• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki 99401 and New vs. Established Patient

Create Wiki
dballard2004

dballard2004

True Blue
Messages
1,319
Location
Overland Park, KS
Best answers
0
I have a question that I hope someone canhelp clarify for me. I think I know the answer to this, but I guess I just need some reasuurance.

A new patient comes into our clinic and all we perform is preventative counseling, CPT code 99401. The patient had no symptoms. I am aware that the CPT book states that code 99401 can be used for either a new or an established patient, but if the patient was new and all we did was the counseling only, code 99401, if the patient returns to us for a sick visit a few weeks later, are they now an establsihed patient?

Now, I say yes because an E/M service was created on the intial visit, but I have a few coders in my office challenging this.

Any opinions? Thanks.
 
Why would they challenge this? The patient was in the office face to face with the physician for services rendered, they are now established. I could be mistaken but I know of no ruleing that cetain services do not count as to make the patient new for the next encounter.
 
I totally agree with you. Why would they challenge this? That is a good question! I agree that they would be established on the return visit, but I guess the coders are thinking that because the patient had no symptoms, they never "established" care.
 
You must log in or register to reply here.
Top