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Pediatric Coding Alert

You Be the Coder:

Newborn Checkup

Published on Fri Dec 01, 2000

Question: Should we charge a new or established evaluation and management (E/M) code when a newborn presents to the office for his 2-week checkup and we initially saw him in the hospital when he was born?

South Carolina Subscriber


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


  Answer: CPT Codes states at the beginning of the E/M services section that a new patient is someone the physician has not seen in the past three years. Therefore, a newborn who was seen in the hospital would not be a new patient, and 99212-99215 (established patient office visits) should be charged.
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