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Neurology & Pain Management Coding Alert

Reader Questions:

Patient Becomes 'Established' After First Visit

Published on Fri May 21, 2010

Question: A patient came to our office and saw one neurologist, but when the patient came back for a follow-up he saw a different neurologist who ended up taking over the patient's case. The two physicians have different provider numbers and tax ID numbers. Their only connection is that they work out of the same hospital and "cover" for one another if one is out of town, which is what happened here. My guess is to use 99201 for the initial encounter and 99231 for the follow-up. Is that correct?California SubscriberAnswer: If the encounters occurred in an outpatient setting, then no. When one neurologist (we'll call her Neurologist A) sees a patient for the first time, you would use one of the office/outpatient E/M codes (99201-99215, Office or other outpatient visit for the evaluation and management of a new patient ...). When another physician (Neurologist B) is covering for Neurologist [...]
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