Billing a new patient as an established pt?

bcousino

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Can a new patient be billed with established patient codes?

I can not find any source to answer this question. I have a note that has no ROS and can not get a three of three for a new patient. I am unclear if I can use established code or if I have to write off charge?
 

mhstrauss

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Can a new patient be billed with established patient codes?

I can not find any source to answer this question. I have a note that has no ROS and can not get a three of three for a new patient. I am unclear if I can use established code or if I have to write off charge?
If, by chance, the physician qualifies to code based on time, that's one possibility. Definitely don't just write the charge off. Another option would be the unlisted E/M code 99499. If it is a Medicare patient, check with your carrier to see how they would like it handled, when the physician doesn't meet 1 of the 3 key elements, or qualify for time-based coding.

Hope this helps! :)
 
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99201

CPT 99201 New Patient requires only a problem focused history - Chief Complaint and 1 element of HPI.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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