Jean hot water Re: (unknown)

[Guest guest]

Wow, Obama is inaugurated, then you get hot water. The two issues

must be related. What a President!;-)Tim

nivedita there is never a charge for

reading the ppd .the code 86580 is for placing and reading it There are never two

separete cahrgesPPD stuff is really quick and cheap She does need to

come in twice but If it was me I would do both the same day charge one c opay and

then she bops by for a 2min reading that you write down for herIF

teh ppd is postive that becomes a visit with copay becasue you need to do work

explaing ordering w/u of course.ONe issue here is HOW the insurance and

billing owrk Which others on this list serv know better than IBut th

eother issue is how you serve the patietn YOu make mor eloyality among patients when you sevre their agenda firs.t If she wants the skin procedure to be done -do

it for herOther caveats PPD is only good for 30 days after

you use it once Good chance you will have ot toss it and buy more before you need

it agian MAke sure your cost covers the whole vial.ALso When patietns

enter your office is the best time to tell them that if insurance does not cover a

procedure and I always state the likley time for that is with cosmetic procedures

,and then when they are requesteing something that is obvioulsy cosmetcitic, I warn

t hem again a nd I tell them my cost I cann't recommedn the hassle and

likley lies you get when calling insurance That is not your responsibility it is

the patietnsWhen we are allied with patietns they can take on these tasks

When we are seen to be here to serve not to figure out how many copays to get, we

keep them and serve them better, and our practices grow 2 cents. minus

12 agian I have hot water thooght(new yesterday)Jean

Thanks for your input.

So should I call the insurance company to see if they will cover the cpt for

ppd and if the pt owes a copay? Doing the two procedures on separate days makes

sense. Just a hassle for the patient though.

Are we expected to routinely prior authorize derm lesion excision/biopsy with

the insurance company prior to services?

Nita

From: RGMS

rgms01@...>To: Sent: Tuesday, January

20, 2009 10:25:56 PMSubject: RE: (unknown)

Nita: May I suggest you place PPD on one day

and have her return 48 hours later for reading and the skin procedure? I would

actually have her pay the co-pay both times…but that is just me. Some

insurance requires the co-pay every time a patient is seen; it is part of the

patient's contract…(and yours if you are in network)

On the other hand, I do not ever charge for the reading

of a PPD as long as it is negative.

I think if you do both on one day there is that always

present risk that the insurance will cover the " lesser " of the two fees,

especially if they do not honor a 25 modifier. Depending on your willingness to

take that risk, you will want to use the modifier for " separate and

identifiable service " on same day.

Finally, if PPD is being placed for employment purposes

only, some insurers will also deny coverage for that purpose. (non medically

necessary)

Ramona

Ramona G. Seidel, MD

www.baycrossingfami lymedicine.

com

Your Bridge to Health

NOTE NEW ADDRESS AND PHONE

NUMBER:

269 Peninsula Farm

RoadSuite F

Arnold, MD 21012

410

518-9808

From: Practiceimprovement

1yahoogroups (DOT) com [mailto: Practiceimprovement 1yahoogroups (DOT) com ] On Behalf Of Dr Levin

Sent: Tuesday, January 20, 2009 10:17 PMTo: Practiceimprovement 1yahoogroups (DOT)

com

Subject: Re:

[Practiceimprovemen t1] (unknown)

Have her come in for PPD placement, but don't charge copay for

that.

Come another time for the skin biopsy.

I

often may have pt come back for immunization later, like a flu shot I wouldn't

charge the copay just for that.

Matt in Western PA

[Practiceimprovemen t1]

(unknown)

Dear

all,

I have an

established patient coming in for a skin lesion removal in a few wks.. She called

stating that she needs a ppd placed for Tb testing and wanted to get both, the skin

procedure and ppd placement done at same visit to avoid 2 copays. This is my first

ppd placement in my new practice and I was wondering..

Do insurance

companies pay for 2 different CPT on same date of visit? (insurance company in this

case is United UHC)

Also, should

one collect a copay for ppd visit & /or when patient comes back for reading? What

is the right way to do this...is the ppd visit considered an office visit..99211 or

99212?

I appreciate

your help on this one!

Nita

-- If you are a patient please allow up to 24

hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD 115 Mt

Blue Circle ph fax 207 778

3544

---------------------------------------- Malia, MD (phone / fax)www.MaliaFamilyMedicine.comwww.SkinSenseLaser.comMalia Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton Square MallFairport, NY 14450-- Confidentiality Notice --This email message, including all the

attachments, is for the sole use of the intended recipient(s) and contains

confidential information. Unauthorized use or disclosure is prohibited. If you are

not the intended recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the sender

immediately by reply email and destroy all copies of the original message, including

attachments.----------------------------------------