Code 97001


True Blue
Best answers
Id check out the LCD for you area. I looked up 2 examples and it basically says it need to be a new, unrelated dx.

Example from Noridian

Evaluation is warranted e.g., for a new diagnosis or when a condition is treated in a new setting. These evaluative judgments are essential to development of the plan of care, including goals and the selection of interventions. The time spend in evaluation does not also count as treatment time.

From NGS

Only one initial evaluation code should be used, and all presenting complaints and problems evaluated. If over the course of an episode of treatment, a new, unrelated diagnosis occurs, another initial evaluation may be covered.
Last edited: