Most Common Visits

[jdgmu33]

What are the most common problems that a family doc will encounter?

How commons are orthopedic complaints?

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[bkpa2med]

I was going to post something similar so I might as well ask in this thread as well. Possibly KentW can answer this question.

Is the reimbursement for a common visit ~$75? I was just trying to calculate gross pay and used that as a number. Can someone please verify this for me?

Thanx!

 

[deleted87716]

You can get an idea of the most common FM diagnoses here: http://www.aafp.org/online/en/home/publications/journals/fpm/icd9/fpmlonglist.html

As for the income question, you might want to read this thread. Post here if you need clarification.

 

[bkpa2med]

You can get an idea of the most common FM diagnoses here: http://www.aafp.org/online/en/home/publications/journals/fpm/icd9/fpmlonglist.html

As for the income question, you might want to read this thread. Post here if you need clarification.

Thanks Kent but I actually read that.
My question is what is the reimbursement for the most common code, not typical salaries.

I was just trying to calculate if you have your own practice, work 10hrs/day, 5 days a week, 48 weeks out of the year and subtract about 60% for overhead what would you expect to get?

Thanks again Kent.

 

[deleted87716]

Coding/billing is way too complex to attempt to explain it here.

Suffice it to say that code selection boils down to medical decision making (e.g., risk and complexity). It's not necessarily based on diagnosis. You don't get paid for seeing a patient with a cough; you get paid for the complexity of the office visit. An established patient visit for a cough could end up being billed anywhere from a 99212-99215. The amount you'll be reimbursed for any particular visit type is carrier-dependent. Using Medicare as a worst-case example ( http://www.cms.hhs.gov/apps/pfslookup/ ), a 99212 reimburses $36.76, while a 99215 reimburses $122.03. My average office visit is a 99214 ($90.20 from Medicare). All of our commercial payers reimburse more than Medicare.

Also, there's more to primary care income than simply office-based E&M codes. Procedures, labs, and other ancillary services can really add up. This is also practice-dependent.

The average family physician sees an average number of patients and works an average schedule to achieve the average income. Figure around 25 patients/day, 40 hours/week, 48 weeks/year, to earn around $160,000.

The average family physician also doesn't do a very good job coding, and typically leaves lots of money on the table.

You don't have to be average.

 

[bkpa2med]

Now that's what I'm talking about. Thanks very much Kent, that brings a BIG SMILE to my face

 

[lateness]

Coding/billing is way too complex to attempt to explain it here.

Suffice it to say that code selection boils down to medical decision making (e.g., risk and complexity). It's not necessarily based on diagnosis. You don't get paid for seeing a patient with a cough; you get paid for the complexity of the office visit. An established patient visit for a cough could end up being billed anywhere from a 99212-99215. The amount you'll be reimbursed for any particular visit type is carrier-dependent. Using Medicare as a worst-case example ( http://www.cms.hhs.gov/apps/pfslookup/ ), a 99212 reimburses $36.76, while a 99215 reimburses $122.03. My average office visit is a 99214 ($90.20 from Medicare). All of our commercial payers reimburse more than Medicare.

Also, there's more to primary care income than simply office-based E&M codes. Procedures, labs, and other ancillary services can really add up. This is also practice-dependent.

The average family physician sees an average number of patients and works an average schedule to achieve the average income. Figure around 25 patients/day, 40 hours/week, 48 weeks/year, to earn around $160,000.

The average family physician also doesn't do a very good job coding, and typically leaves lots of money on the table.

You don't have to be average.

thats one of the best posts summing up a lot, in a short paragraph..

 

[jdgmu33]

Thanks for the ICD codes Kent, but I was looking for something like a top 10 list of most common family med visits

I remember seeing something like that while on my 3rd year clerkship

I specifically would like to know what percentage of primary care visits are orthopedic complaints

You can get an idea of the most common FM diagnoses here: http://www.aafp.org/online/en/home/publications/journals/fpm/icd9/fpmlonglist.html

As for the income question, you might want to read this thread. Post here if you need clarification.

 

[deleted87716]

Thanks for the ICD codes Kent, but I was looking for something like a top 10 list of most common family med visits

I remember seeing something like that while on my 3rd year clerkship

Oh, you mean like this?

Top 10 Diagnoses in Family Practice Office Visits in 2001 - % of Office Visits

Hypertension NOS - 8.4%

Diabetes Mellitus, Uncomplicated - 3.4%

Chronic Sinusitis NOS* - 2.8%

Acute Upper Respiratory Tract Infections NOS* - 2.7%

Bronchitis NOS* - 2.4%

Hyperlipidemia NEC**/NOS* - 2.2%

Acute Pharyngitis - 2%

Depressive Disorder NEC** - 1.8%

Routine Medical Exam - 1.8%

Otitis Media NOS* - 1.6%

*Not otherwise specified. ** Not elsewhere classified

Note: Based on a monthly survey of about 500 office-based family physicians, who reported on the number of visits for each condition.

Source: http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=499

Take this with a grain of salt, obviously, as it's going to be practice-dependent to a large extent. For me, otitis media definitely wouldn't make the top ten.

Also worth noting is that in total, these common complaints make up only about 30% of the total office visits. There's plenty of other stuff out there making up the other 70%. People who say, "Oh, all you do in FM is treat runny noses all day" are missing that point. This sort of list also overlooks the added complexity of multiple comorbidities. Rarely are you seeing someone with hypertension who has nothing else going on.

I specifically would like to know what percentage of primary care visits are orthopedic complaints

I haven't been able to find any numbers on that, sorry.