Q&A: Coding for monitoring patients who have ongoing medical problems

March 20, 2009

It is appropriate for primary care doctors to code for visits for patients who request blood-pressure checks and lab slips but who come in without complaints. Primary care doctors are an important part of effective ongoing patient care.

Q: We have a number of patients who make appointments to request blood-pressure checks and lab slips, but who come in without complaints. They may have ongoing medical problems, but they are seeing specialists for those ailments. What would be the appropriate CPT and ICD-9 codes to use to process these visits?

A: The first thing that comes to mind is, if the patient simply wants a routine physical without complaints, that's the type of appointment that should be scheduled. Those types of visits are billed with the 993 series of codes as appropriate and the ICD-9 series of V codes describing preventive services.

The second thing that comes to mind is: Why would the patient be requesting a blood-pressure check, and what is the lab work ordered for? While the specialists are following the patients for other ongoing medical problems, it is important to determine what the primary care physician is following the patient for. Controlled hypertension (is that why the patient is requesting a blood-pressure check?) or hyperlipidemia (is that what the lab slip is for?) may be under control, but interval monitoring is good patient care, especially if the results are then discussed with the patient at a later time.

Primary care doctors are an extremely important part of effective ongoing patient care-don't discount your services.

The author, vice president of operations for Reed Medical Systems in Monroe, Michigan, has more than 30 years of experience as a practice management consultant and is also a certified coding specialist, certified compliance officer, and a certified medical assistant.