Wiki New IPPE and E/M same patient/same day

[Plaw4444]

When reporting both a new patient preventive care visit (99385) and a medically necessary E/M service (e.g., 99204) on the same day for a patient, should both codes reflect 'new patient' status, or should the E/M code reflect an established level (99214) since 99385 already defined the patient as new? I already know that CMS/Medicare does not recognize IPPEs- that's not my question.

 

[rmness]

When reporting both a new patient preventive care visit (99385) and a medically necessary E/M service (e.g., 99204) on the same day for a patient, should both codes reflect 'new patient' status, or should the E/M code reflect an established level (99214) since 99385 already defined the patient as new? I already know that CMS/Medicare does not recognize IPPEs- that's not my question.

You would have to check your payor policies. Our facility codes the problem E/M as established as most of our payors policies state they will now allow two new patient codes and direct us to use established on the problem E/M's.