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mojolady
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发表于:2022-06-27 14:10|只看楼主
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求问美国专科看诊bill

一个印度医生,专科看诊费用 10分钟的zoom meeting,charge了45~60min的code:99204,这是什么情况?


因为马上要到这个医生那里做胃镜,感觉这个人做事不太合规矩,有点担心。。。

最后编辑mojolady 最后编辑于 2022/06/27 14:15:13

你知道论坛有打赏功能吗?!遇到喜欢的主题可以用你的论坛魅力给贴主“打赏加油”

功能说明点这里

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oqo
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发表于:2022-06-27 14:20|只看TA
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一个印度医生,专科看诊费用 10分钟的zoom meeting,charge了45~60min的code:99204,这是什么情况?


因为马上要到这个医生那里做胃镜,感觉这个人做事不太合规矩,有点担心。。。


mojolady 发表于 2022-06-27 14:10

换医生


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bye2020
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发表于:2022-06-27 14:22|只看TA
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这个可以跟保险公司投诉upcoding
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mojolady
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发表于:2022-06-27 14:27|只看楼主
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这个可以跟保险公司投诉upcoding
bye2020 发表于 2022-06-27 14:22

刚刚查了一下,这个医生在after visit summary里写:

The total time spent preparing to see the patient, obtaining or reviewing history obtained, performing exam and evaluation, counseling and education of patient/family /caregiver, ordering medications, tests, procedures, referring and communicating with other healthcare providers , documenting in the EHR, independent interpretation of results and care coordination / medical discussion was 45 minutes.


明显,他把他meeting之外的时间也算在我的meeting里了,这个合理吗?

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steve888
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发表于:2022-06-27 14:31|只看TA
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刚刚查了一下,这个医生在after visit summary里写:

The total time spent preparing to see the patient, obtaining or reviewing history obtained, performing exam and evaluation, counseling and education of patient/family /caregiver, ordering medications, tests, procedures, referring and communicating with other healthcare providers , documenting in the EHR, independent interpretation of results and care coordination / medical discussion was 45 minutes.


明显,他把他meeting之外的时间也算在我的meeting里了,这个合理吗?


mojolady 发表于 2022-06-27 14:27

合理。规矩是这么算的。

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mojolady
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发表于:2022-06-27 14:35|只看楼主
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合理。规矩是这么算的。


steve888 发表于 2022-06-27 14:31

可是Bill code里明确说明45分钟是face-to-face的,你看下面👇


CPT 99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.

Billing Instructions: Bill 1 unit per visit.



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gokgs
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发表于:2022-06-27 14:46|只看TA
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都这样吧? 一般都是五六分钟搞定。

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summerfallisme
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发表于:2022-06-27 14:48|只看TA
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回复 1楼mojolady的帖子

我不论看家庭医生还是专科医生都是charge的code比实际花的时间多,或者诊疗没有到达code描述的复杂程度。反正付copay就行了,就没有管。他们跟保险公司要钱多。

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mellamoperro
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发表于:2022-06-27 14:51|只看TA
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99204以前会有一个时间上的要求,去年开始的coding改革后就不需要了。

满足99204,更取决于医生给你的诊断有几个,有没有开药,有没有开检查,有没有和你review之前的记录。

以上几点满足几个就可以了。程序上完全合规。

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steve888
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发表于:2022-06-27 14:58|只看TA
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可是Bill code里明确说明45分钟是face-to-face的,你看下面👇


CPT 99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.

Billing Instructions: Bill 1 unit per visit.




mojolady 发表于 2022-06-27 14:35

你这个哪里找的。手册上没有face to face这一说。只说当天花了45-49分钟就行。另外不用时间选code也行,新病人或者中等严重的都可以用这个。

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