Billing/Coding

[gaschicago]

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Are people billing level 5 visits for any of their encounters (99205/99215)? If so what type of encounters are you billing this for?

Not looking at using time based metrics to justify level 5 visit.

 

[Ferrismonk]

A pain visit rarely requires a level 5 visit, so rarely.

 

[PinchandBurn]

I have never used it.

Except 1 time based on time. But this is one time in 12 years!

 

[runfastnow]

Maybe 5-6 times per year. I'm PM&R sports/spine so sometimes I'll get some PM&R/neuro stuff that comes in.

Our EMR does a good job tallying up points in each section for the "new" Medicare billing guidelines so I don't have to think too hard about it.

For new patients it usually takes concern for significant underlying neuro condition that has been misdiagnosed/undiagnosed + enough data points to hit 99205.

For the handful of trainwrecks and post-stroke/TBI/SCI patients I have as follow up sometimes I get 99215 based on time - but rare.

 

[lobelsteve]

2-3x per year.

 

[drrosenrosen]

Last one I did was for a pt who I diagnosed as having an MI and sent by EMS to the ER. It was an easy call - SOB, CP, pouring sweat.

 

[MitchLevi]

Level 5 f/u or NPV...A few per yr each. Rare.