Wiki A new patient annual and problem

[kterry0474]

If a new patient is coming in for a well woman exam 9938X and then a problem is discussed, should the new problem be billed with a 9920X code? I was always told no. The patient can only be new once so the Annual would be new and and the problem would then be established? Is this incorrect?

 

[Cmama12]

If a new patient is coming in for a well woman exam 9938X and then a problem is discussed, should the new problem be billed with a 9920X code? I was always told no. The patient can only be new once so the Annual would be new and and the problem would then be established? Is this incorrect?

Way back when I first started coding, we did it that way, but that changed a while back and we code as new/new. They are still new at that appointment. I don't really have a resource or anything though (did a quick look)

 

[pclaybaugh]

Without more information my take on this is, allowable when the problem receives treatment and the documentation supports medical necessity. Code the E/M with a modifier 25.
Consult your CPT book under the Preventative Medicine Services as it states that If an abnormality/ies is encountered or a pre existing problem is addressed in the process of performing this preventive medicine evaluation and management service, and if the problem/abnormality is Significant enough to require additional work to perform the key components of a problem-oriented service, then the appropriate Office/Outpatient code 99201-99215 should also be reported.