99173 - vision screening, what to charge

>----- Original Message -----
>From: "Daniel Frieling"
>
> > Hello all,
> >
> > What have you been charging for 99173 vision screening. Have you been
> > getting paid on them?
> >
> > Thanks,
> > Danny
> >

At 09:12 AM 5/11/2004, Brenda Roderick wrote:

>We don't get paid for these when done as part of the wellness visit. It's
>considered inclusive of the well visit. We do get paid for them if we have
>a medical reason to do them.

According to the AAP book, "Coding For Pediatrics" these should not
necessarily be inclusive of the well visit and can be reimbursed
separately. A few years ago I faxed the appropriate pages from the book
to the provider relations rep at a major PPO and a couple of weeks later
received a personal call from the plan's medical director telling me that
after reviewing the documentation I sent the insurance company would begin
paying for these codes in addition to the well visit. Not all companies
are so responsive, but the reimbursement from this one company over the
past few years sure made the time I spent worthwhile.

Michael Sachs, M.D.
General Pediatrician