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Wiki New Pt Preventative and E/M

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LKaf7

Networker
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Location
Parma, OH
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Hello,

I am looking for some clarification. When a new pt comes in and sees the provider for preventative services (99385) but then also ends up going over a separate issue and has proper documentation would a new pt E/M or establish E/M be billed. I'm having a hard time finding a clear answer on this.

Thank you!
Leah Kafantaris
 
Here is some guidance from ACOG that may help you (see attachment). Keep in mind many payers have their own guidelines for how they want these services reported. You should contact the payer and get it in writing. Some do not want 2 E/M services reported on the same day so when that is the case you would bill for the predominate service.
 

Attachments

Thanks!

Thank you for the info! I understand most payers have their own guidelines. I'm trying to find documentation to give to our providers on the correct way to handle this, but seems like it all depends on the payer I guess.

Thanks again!
Leah
 
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