new patient

  1. A

    First listed diagnosis for surgical evaluation for colon polyp

    Hello, I'm a new CPC-A and I'm trying to understand how to select diagnoses for office visits. Am I selecting the diagnosis based on the reason for the visit? Or for the patient's condition at the time of the visit? I know it can be the first one if a diagnosis is not established, and the second...
  2. K

    Question NPP and Collaborating Physicians

    Please provide guidance and documentation. Can a collaborating physician be listed as the referring provider on a new patient claim for a NPP if the patient has never seen the collaborating physician?
  3. KStaten

    Question Who Has Documentation Permissions per Medicare Guidelines?

    Hello Everyone! :) I am trying to put a table together to describe components of a medical document for a typical outpatient setting office visit and list who (per Medicare guidelines) has permission to document each one. In other words, in order to correctly bill under the physician, what...
  4. A

    Question New vs Established Patient Clarification

    Hello Fellow Coders, I have a new provider to our group who saw a patient that he previously saw 2 1/2 years ago at his old practice, which has a different tax-id. The patient has Medicare and received a denial that only one evaluation and management code at this service level is covered...
  5. D

    CO 252 rejection code - what information are they lacking?

    Hi everybody! This is the first time I'm writing here. I have a strange claim that was denied with CO 252 code and the appeal wasn't successful either. The clinical was attached but they still say that after consideration they don't think that the visit is as complex as they need for 99205 (new...
  6. M

    Billing E/M code for new pt STD screening only

    Our provider sometimes sees new patients at our walk-in clinic who only want STD screening and have no symptoms. An ROS and brief exam are always done. Can I bill an E/M code for these cases or just the lab draw?
  7. K

    Can PAs and NPs see a NEW Medicare Patient?

    Hi there, I work in a Dermatology practice and there has been some discussion over billing for PAs and NPs... I'm wondering: Can PAs and NPs see NEW Medicare Patients? Thanks!!
  8. K

    New Patient Exams

    Recently I attended the WAEPS billing code quest seminar and something the speaker said raised a lot of questions. I have always billed a new patient as a patient that has not been seen by our practice in the last three years or at all, but the speaker said that if a patient is seen by a...
  9. B

    New Pt Qualifications

    We had a patient that was seen for a Flu shot only (no face to face with any provider, MA only) and then came back for their first visit with the provider on a different day. Would you consider this a New or Est. Patient? We sent it as a New patient and was denied, saying we don't meet the new...
  10. C

    consult or new patient?

    1. If physician sees a patient who has paperwork that says “referral” or “transition of care” on it from the PCP or other referring provider, is this a consult or a new patient e/m? We have seen some of this paperwork have “referral” and “consult” on the same pages and my physician wants to...
  11. J

    "Consult" with a patients parent only

    Hello. I have a unique situation. My provider had a new patient appointment for a "consult" of twin girls with development issues. However this is not a true consult in that the parent initiated the appointment not a referring provider and only the parent showed up for the appointment. Is there...
  12. J

    New Issue/New Provider?

    Hello! I work for a clinic with multiple providers at multiple locations. Frequently, a patient will be seen by a PCP at one location, be diagnosed with a chronic issue (ie, hypertension) then, switch locations and PCP's. They will come to see their new PCP with the hypertension, and the new...
  13. J

    New Patient visit with no Dx?

    I have run in to an issue where one of my providers has a new patient appointment where all the patient wants to do is establish a relationship with the provider. This patient has nothing medical wrong with them (not on any Rx nor has any chronic issue and not currently sick). What dx code would...
  14. L

    General Counseling versus Surveillance

    Scenario: Patient is new to our clinic with an exisiting Rx for Nuva Ring. She also request information on IUD & has s&s of BV. Pt was given a new Rx for the Nuva Ring, pamphlets on IUD and a wetsmear with negative results for BV. As far as the diagnosis coding for the Nuva Ring, would you...
  15. N

    New patient vs Est patient

    Recently a FNP joined the Pediatric group that I manage. Some of the patients that she saw at her other practice have followed her over here. I say that these patients are established, as she has seen them within the last three years. Her and the physicians are saying the patients are new...