Well Exams

When a patient comes in for their annual Well Exam and has their annual labwork done what ICD-9 should be used to bill this labwork. It seems whatever we use we are having trouble with payment.

Thank you,

Sue

well

If whatever you use is causing trouble, use something else ;-)

I link the basic labs to the V70.0 except PSA to v76.44 and hemoccult to v76.41 and pap to v72.31. if it is a well exam and they are diabetic and hypertensive, I link the Hba1c to 250.00 and the urine protein to 401.1 since these are not normally part of a well exam. Payment depends on the insurer benefit- there may be a price limit so they pay up to $500, or a CPT limit where they only pay the 99395. And the biggest issue I have seen is insurers that only pay for labs performed on the day of the exam so if you have you patients come in a week early and get labs in preparation, you'll get denied. It's a guessing game really.