Author Topic: Billing 99213 - does this include all diagnosis codes old and new?  (Read 1377 times)

2012billingrep

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When billing for an established patient re-exam 99213, the doctor is examing the patient for their initial diagnosis codes as well as new symptoms being presented that day. Following the re-exam, if they a) finished their treatment plan for original diagnosis and will no longer be treating that and b)have now got new symptoms with corresponding new diagnosis codes, do I point the 99213 towards the old AND new codes and then remove the old diagnosis codes for future claims?
OR do I remove the original diagnosis codes and just put the new diagnosis codes and point the 99213 towards the new codes?

Michele

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Re: Billing 99213 - does this include all diagnosis codes old and new?
« Reply #1 on: October 11, 2015, 02:15:19 PM »
The diagnosis codes on the claim should be whatever codes represent what the patient is being seen for in that visit.  Diagnosis codes from previous visits should not be carried over.  I hope I understood your question.
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kristin

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Re: Billing 99213 - does this include all diagnosis codes old and new?
« Reply #2 on: October 11, 2015, 07:43:11 PM »
Agree with what Michele said. Dx what happened at that visit. All software I use allows me to either change the dx's in a case if needed, or to create a new case. I don't know what software you are using, but you should be able to do the same.

2012billingrep

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Re: Billing 99213 - does this include all diagnosis codes old and new?
« Reply #3 on: October 11, 2015, 08:27:18 PM »
Thank you for the responses. I was just concerned as there would be a lot of codes for this one claim ie 7 codes instead of the usual 3-4 that I bill for this practice.

Since the doctor is re-examining the patient's initial issue, the original diagnosis codes are currently at position 1,2,3,4. If there were 3 new diagnosis codes to include in this case, for this particular claim, would they be at position 5, 6 and 7 or would they be placed at position 1, 2, 3? If they are to be at position 5, 6, 7, would I then move them to position 1, 2, 3 for the next claim (and remove the original diagnosis codes altogether as they no longer apply) as this is what the doctor would be treating for over the next few visits?

Hope that made sense...

kristin

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Re: Billing 99213 - does this include all diagnosis codes old and new?
« Reply #4 on: October 12, 2015, 05:51:52 PM »
Well, you are only allowed four diagnosis pointers per claim line. So the 99213 can only have four diagnoses total assigned to it. Ideally, you want the four diagnoses that are the most important for that visit assigned to it, in positions 1-4. What software are you using?

Michele

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Re: Billing 99213 - does this include all diagnosis codes old and new?
« Reply #5 on: October 12, 2015, 07:54:04 PM »
If the doctor is still treating conditions from the previous visit then they can be included.  There is room for 12 dxs on the claim but as Kristin said, there are only four dx pointers per claim line so the most important four should be listed first.
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