Medical Billing and Coding Notes

Patient Information: - Patient ID number: 123456789 - Patient name: John Doe - Address: 123 Main Street, Springfield, IL, 62701 - City/State: Springfield, IL - Social Security number: 987-65-4320 - Phone number: (555) 123-4567 - Date of birth: 15 March 1980 - Age: 44 Payment Method: - Primary: Blue Cross Blue Shield, ID: 987654321, Group: 12345 - Secondary: United Healthcare, ID: 123456789, Group: 67890 Visit Information: - Visit date: 1 November 2024 - Visit number: 20241101-001 - Rendering physician: Dr. Emily Smith - Referring physician: Dr. Thomas Kelly - Reason for visit: Routine check-up and blood pressure management Modifiers Section: - E/M Modifiers: 25 - Procedure Modifiers: 59 Procedure and Coding Grid: - CATEGORY: Office Visit – Established - CODE: 99213 - MOD: 25 - FEE: $150.00 Vitals: - B/P: 130/85 - Pulse: 72 bpm - Temp.: 98.6°F - Height: 5'10" - Weight: 180 lbs Other Visit Information: - Lab Work to Order: Complete Blood Count (CBC), Lipid Panel - Referral to: Cardiologist - Provider Signature: Dr. Emily Smith - Next Appointment: in 3 months Fees: - Total Charges: $150.00 - Copay Received: $20.00 - Other Payment: None - Total Due: $130.00