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Re: GEN: Billing From: Anna Meenan, MD (annam@uic.edu) Mon Feb 2 10:52:16 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anna Meenan, MD: "Re: Missed deliveries" Previous message: Ana : "Re: contraception in breast cancer" In reply to: Garry E. Siegel, M.D.: "GEN: Billing" Next in thread: Garry E. Siegel, M.D.: "Re: GEN: Billing" Reply: Garry E. Siegel, M.D.: "Re: GEN: Billing" Why let your nurse see and bill at a low level E/M? UTI is a 99213 and only takes about 5 min or less. Have your nurse order a U/A on pt's arrival in the office and go in to see the pt when it comes back from the lab. Hx: Onset? Dysuria? Frequency? Back pain? N/V? Has she taken anything for it? LMP? Recent new partner? Px: Palpate abd and check for CVA tenderness write Rx. That's a 99213 guys, in well under 5 min. Don't throw it away. In our office we have a policy of not calling in antibiotics under any circumstances. If it's a weekend, they can go to the doc-in-the-box and s/he can bill the 99213. There is a code for phone stuff, but NOBODY PAYS. If we all refuse to manage things like this over the phone, maybe the insurance companies will eventually see that it's cheaper to pay on that phone code and start paying. If pt's gripe about having to come into the office, we tell them ever so cheerfully that there's just too much liability involved in attempting to diagnose things over the phone. I personally think that's true these days. I have actually picked up the occasional case of chlamydia urethritis masquerading as common cystitis by insisting the pt. come in. -- Anna Meenan, MD At Sun, 1 Feb 2004, Garry E. Siegel, M.D. wrote: > >I know that there are CPT codes for telephone work, and I also am pretty >sure that no carriers will reimburse for them. > >Here's a scenario that is handled differently on weekdays versus >weekends. > >An existing patient calls with UTI symptoms, gyn, and wants an Rx. >Normally, we insist on them coming in for a urinalysis, maybe a culture, >and then prescribe. This allows us to make a correct diagnosis, see >them if necessary, etc. This is billable as a low level E/M service if >the nurse handles it. > >OK, now on the weekend, same story, but I sometimes send the patient to >the hospital lab for the u/a and culture, and have to: >1. Call the patient back. >2. Fax an order to the lab (forget verbals these days). >3. Call in the Rx. >4. Document a note, which I do. > >I think that I should bill the same entry level office E/M service. > >What do you guyst think? If there are any coders out there, please weigh >in. > >Private email OK, too. > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > Next message: Anna Meenan, MD: "Re: Missed deliveries" Previous message: Ana : "Re: contraception in breast cancer" In reply to: Garry E. Siegel, M.D.: "GEN: Billing" Next in thread: Garry E. Siegel, M.D.: "Re: GEN: Billing" Reply: Garry E. Siegel, M.D.: "Re: GEN: Billing"

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