Billing Question


Owings Mills, MD
Best answers
A Patient Comes In For A Procedure But Is New To The Physician Can We Bill For A New Patient Ov As Well As The Procedure If The Physician Does An H/p?
The CPT book gives the guidelines for billing both an E/M and a Preventive visit on the same date of service under the "Preventive" section. It states that both and E/M & a Preventive Exam can be billed using a (-25) on the E/M if "...problem/abnormality is significant enough to require additional work to perform the key components of a problem-oriented E/M service, then the appropriate Office/Outpatient code 99201-99215 should also be reported." Hope this helps...also, the "AAFP" website has some good articles regarding this same issue.:D
Oh! Chequita...I'm so sorry, I misread your question; I apologize. It is my understanding that a procedure and a new patient visit can be billed if the e/m is "significantly identifiable" from the procedure by appending either a
(-25) or a (-57) modifier (depending on the procedure's global days).