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You Be the Coder: Established Patient Consults

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: Ive got a patient whos proving resistant to several different kinds of vaccines. She keeps coming in for consults, and I know that she needs additional antibiotics for me to effectively treat her difficult condition. But what codes should I use to make sure we get paid for additional consults and antibiotic treatments?

Maryland Subscriber

Answer: Use code 99212 for a limited, established patient visit. Remember, you must always document the need for prescribing additional antibiotics or laboratory tests. You should document the increase in symptoms to justify the patient visit. In addition, if you are treating a patient with AIDS or HIV, you should put the National Drug Code (NDC) number, found in the Red Book, on the HCFA-1500 Billing Form. In addition, as it now stands, you must mail this form and not electronically submit it to the proper authorities.

- Published on 2000-05-01

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