Hi there,
I’m looking for some help understanding whether my doctor’s appointment was coded accurately. Thanks in advance for taking a look and sharing your expertise!
I went into my doctor’s office as a new patient for what was described as a “new patient meeting.” Here’s what happened:
My weight, height, blood pressure, etc. were taken, reflexes tested, etc. We went over my health history. This took about 10 minutes because the online form I filled out wasn’t in their system and they didn’t request my history from my previous doctor even though I gave them all the info/signed the form for doing so. I told my doctor about the one medication I take, an antidepressant. My medication manages my symptoms well, so I was just looking to continue my current prescription. She had me fill out three kinds of “are you depressed/abused” kind of checklists. I told her about an inflamed lymph node behind my ear that has stuck around for a while. She took a 1-minute look at it and referred me to an ENT just to see if they want to biopsy it, but didn’t think it was likely of concern. My doctor ordered blood tests. She said she does this for all new patients. Overall, the appiontment was 30-35 minutes, though I was there for over and hour since they were busy/running late.
This was billed as a 99204, which isn’t covered as an annual exam under my health insurance. It’s a medical diagnostic appointment. So instead of paying just my copay, I owe over $250.
Does this sound like it fits a 99204, or should it be a 99203? I’ve been trying to work with my doctor’s office on it, but they won’t budge. If it sounds correct, then I suppose I’ll just have to pay it.
I’m just kind of shocked. I’ve always had doctors work with me to ensure procedures are covered (the OB/GYN who did my bisalp coded it as a tubal, for example, so my insurance would cover it), so it’s kinda of frustrating to have the exact opposite happen.
submitted by /u/athanasia_
[link] [comments]Hi there, I’m looking for some help understanding whether my doctor’s appointment was coded accurately. Thanks in advance for taking a look and sharing your expertise! I went into my doctor’s office as a new patient for what was described as a “new patient meeting.” Here’s what happened: My weight, height, blood pressure, etc. were taken, reflexes tested, etc. We went over my health history. This took about 10 minutes because the online form I filled out wasn’t in their system and they didn’t request my history from my previous doctor even though I gave them all the info/signed the form for doing so. I told my doctor about the one medication I take, an antidepressant. My medication manages my symptoms well, so I was just looking to continue my current prescription. She had me fill out three kinds of “are you depressed/abused” kind of checklists. I told her about an inflamed lymph node behind my ear that has stuck around for a while. She took a 1-minute look at it and referred me to an ENT just to see if they want to biopsy it, but didn’t think it was likely of concern. My doctor ordered blood tests. She said she does this for all new patients. Overall, the appiontment was 30-35 minutes, though I was there for over and hour since they were busy/running late. This was billed as a 99204, which isn’t covered as an annual exam under my health insurance. It’s a medical diagnostic appointment. So instead of paying just my copay, I owe over $250. Does this sound like it fits a 99204, or should it be a 99203? I’ve been trying to work with my doctor’s office on it, but they won’t budge. If it sounds correct, then I suppose I’ll just have to pay it. I’m just kind of shocked. I’ve always had doctors work with me to ensure procedures are covered (the OB/GYN who did my bisalp coded it as a tubal, for example, so my insurance would cover it), so it’s kinda of frustrating to have the exact opposite happen. submitted by /u/athanasia_ [link] [comments]Read Morer/HealthInsurance