jbhuju
Guru
pt had preventive visit, office visit and vaccine
example
99386
99213
90715
90471
do i add modifier 25 on both 99386 and 99213 ?
example
99386
99213
90715
90471
do i add modifier 25 on both 99386 and 99213 ?
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Wiki how to bill the scenario
- Thread starter jbhuju
- Start date
OpenClaims
Guest
Yes, you'll need to do the following in order to get all paid. Keep in mind that some payors don't want to pay the separate E/M but I typically send back to them that both encounters are supported and correct per documentation. Have you been advised by your team to code a new patient CPE and an est. patient E/M? The guidelines says to code both as new patient. Some facilities don't practice this, so talk to your superior about what their guidance would be.
codingintel.com
99213-25
99386-25
90715
90471
Can we bill a new patient visit for preventive and E/M services on the same day?
A physician sees a patient for a preventive medicine service and addresses an acute, significant problem. The patient is new to the provider.
codingintel.com
99213-25
99386-25
90715
90471
jbhuju
Guru
thank you so much for the clarificationYes, you'll need to do the following in order to get all paid. Keep in mind that some payors don't want to pay the separate E/M but I typically send back to them that both encounters are supported and correct per documentation. Have you been advised by your team to code a new patient CPE and an est. patient E/M? The guidelines says to code both as new patient. Some facilities don't practice this, so talk to your superior about what their guidance would be.
Can we bill a new patient visit for preventive and E/M services on the same day?
A physician sees a patient for a preventive medicine service and addresses an acute, significant problem. The patient is new to the provider.
99213-25
99386-25
90715
90471
and yes bot cpt are new 99203 i am sorry i did 99213 on my question - Messages
- 1
- Best answers
- 0
Can we bill CPT 99386 alone? I'm getting a CO-97 & M-15 denial codes.
Scenario... Doctor seen patient at Orthopedic Clinic 1 in 2023 for Right Knee Pain. Doctor now has a new practice with a different NPI number and saw the same patient in 2025 for Right Knee Pain. Can we bill a 99203
amyjph
True Blue
No. It is established to the provider (as a person) not where they practiced. Same patient, same provider within 3 years=established.
Thank you