David,
One additional thought, and I do not recall the code #, but on occasion I have used the extended visit charge. I have not done this with the annual, 99213, modifier combination, but with a 99214 that takes more than the designated time. I am away from the office, but can let you know which code #, but this worked without a problem in the past. However, if tied in with an annual, 25 modifier and 99214, I do not know if that would pass muster or not.
I think some of the complexity of care, we just take in the shorts, but I am open to ways of capturing the work we do so we can get the best reimbursement. Also I have a partner that does flight physicals, and I will see if he has any ideas.
