Pediatric Coding Alert
Reader Questions:
'No Charge' Visits Still Count Toward Established Patient Status
Published on Mon Apr 06, 2015
Question: Our pediatrician saw a patient during a quick assessment last year at no charge. The mother returned with the child this week for a complete exam. Should this be billed as an established patient or new?
Codify Subscriber
Answer: In this situation, the patient will be considered “established” because you already treated him during a face-to-face encounter within the last three years, which constitutes an established patient under the CPT® guidelines.
Related Articles
Other Articles in this issue of
Pediatric Coding Alert
- Is Your Newborn Care Documentation Missing This One Crucial Factor?
Scrutinize the notes for discrepancies before selecting your code. Although you might have CPT® code [...] - Compliance:
3 Recent Cases Show Pediatric Fraud Vulnerabilities
Tighten up your practice’s compliance plan to ensure audit success. State Medicaid providers have stepped [...] - ICD-10:
Your Top 3 ICD-10 Questions-Answered
Hint: Keep on using your modifiers the same way after Oct. 1 With the ICD-10 [...] - Billing:
These 6 Tips Will Transform Your Accounts Receivables
Coordinate back office and front desk staff to keep cash flow positive. You know you’re [...] - You Be the Coder:
Heed Insurer Preference on New Patients
Question: If a provider of a different specialty within the same group sees the same patient [...] - Reader Questions:
'No Charge' Visits Still Count Toward Established Patient Status
Question: Our pediatrician saw a patient during a quick assessment last year at no charge. The [...] - Reader Questions:
Tylenol Administration Isn't Separately Billable
Question: Our physician saw a patient with a fever—he had her take Tylenol orally, then had [...] - Reader Questions:
Look to 94780-94781 for Car Seat Testing
Question: We often show patients how to maneuver the car seat and recently heard this is [...]
View All
