New Patient w/ Problem
One more thing ...
The new patient may have initially scheduled a "well woman" exam (99386), but if the physician encountered a problem that required evaluation and management separately from the usual preventive exam, you can code the new patient visit at the same time. You need to carve out the specifics of each type of visit in the documentation (two notes would be ideal).
The key here is that both services occur on the same date ... the patient is still "new."
For example, I go to see a new physician to establish care - routine physical.
While there, I mention that I also have a persistent cough, for which he does some additional evaluation, and prescribes a cough suppresant. He can code both the preventive visit and the new patient visit if he has documentation to show two clearly separate types of service. (And you'd use mod -25 on the new patient visit code.)
Hope that helps.
F Tessa Bartels, CPC, CEMC