Sara M asks a follow-up to last week’s question
First here’s last week’s query:
Dr. Tom
When a patient is seen outside of the office and their x-ray with a reading of pneumonia comes through my in-box, do I really have to have them come in for a visit to make sure it’s submitted? Can’t I just code it from the x-ray?
Sara
Excellent (and common) question.
No.
You can’t submit codes directly off of imaging reports, you have to address the issue with the patient through a “qualified encounter.”
These include office visits, house calls, institutional visits—even ER or Urgent care.encounters.
And now, the follow-up
“Can I just call the urgent care and ask them to submit an addendum for me?”
Sure—and if they’ll do that you will have found an urgent care partner for life.
Long ago, I went over my patient’s discharge summaries when they were admitted to outside hospitals. When I found missed diagnoses, I called their medical records office and asked them to submit additional codes.
I was certain they actually did what they said—it was in their interest and I tracked some diagnosis in test cases.
It’s not really in the urgent care’s interest to submit additional codes. They don’t get any more money from doing so. If they agree to do an addendum, make yourself a note to check to see if it was done.
Personally, I don’t think it’s worth the time.
Instead, contact the patient in follow up and ask them to come in. If they won’t offer to do a house call—and enjoy the shocked silence on the other end of the phone.