Medical Visit types: Q & A

 

We follow all standardized CPT coding guidelines as established by the American Medical Association and insurance regulations placed on the use of this coding.

 

What sorts of visits do we provide and what is/is not included in that visit? 

 

Annual Wellness Visits (child and adult)

 

This appointment is focused on preventive care, health screenings and wellness planning.  Regular medical care, even when you feel fine, can be a crucial part to staying well in the future. Many health issues and future risks can be recognized early and managed to promote a healthier life. This is not a visit for evaluation or diagnosis of new conditions or changes in management of current conditions.

 

Well exams adults may include:  A physical exam, screening for cholesterol, blood pressure, diabetes, mammogram, pap test, osteoporosis, colon cancer, prostate cancer, immunizations, STDs, and other potential recommended tests for certain other health risks based on your health history.  Your provider may ask you about physical activity, diet, drug use such as tobacco and alcohol.  This may also include routine management of stable health conditions that do not require changes in care.  However, if you have many health issues, we will not be able to combine them with an annual wellness visit as it will detract from the purpose of your annual wellness exam.   In this situation, our medical team will ask you to choose either a wellness exam or a problem-focused visit and to schedule a separate appointment for the other.

 

Adult well exam schedule:  Yearly.

 

Well exams for children may include:  Development screening, immunizations, potential STD screens as risk assessed, certain lab screens such as lead/anemia/TB screening, diet, exercise and counseling on safety/managing emergencies.

 

Child well exam schedule:

• Birth (shortly after discharge from a birthing center)

• two weeks

• two months

• four months old

• six months old

• nine months old

• 12 months old

• 15 months old

• 18 months old

Yearly from the ages of two years to 18 years
 

IMPORTANT:  ***Adult and child well exams do not include***:

• New evaluations of any symptoms/conditions.

• Treating current issues that are not stable, requiring medication changes, additional evaluations, or that require labs/further evaluations outside of a traditional wellness visit. etc.

• Procedural treatment of any type for any conditions.

 

Though we may encourage communication about new issues during your well exam, those issues are evaluated and managed in a different type of visit and must be scheduled accordingly (see Problem Focused Visits).

 

Problem Focused Visits

 

This includes evaluation and management of new or existing medical concerns, diagnoses, illnesses, or conditions.

 

Examples include:  skin issues, injuries, infections, allergies, mental health issues, diabetes, high blood pressure, high cholesterol, endocrine issues, travel visits, etc.

 

It is important to communicate all issues accurately with your scheduler because they adjust visit time based on this.   If there are a lot of issues, they may need to be prioritized by you and our medical team and then evaluated in more than one visit.

 

Procedural Visits

 

These are visits that typically include already diagnosed conditions that will be treated procedurally.  

Examples include: skin and other biopsies/excisions, fracture care, IUDs, vasectomies, etc.

 

Can I schedule more than one visit type in the same day?

 

Though we realize it may be convenient to try to get all of this done together in one day, insurance carriers do not provide benefits to you when these different types of visits are done together.   Therefore, it is important to know what you are scheduling for, what is included in that visit, and what is not.  These types of visits cannot be combined on the same day.  We are happy to address all your needs, but we need to do it with the confines of insurance guidelines for these types of visits.  Thank you!