Pre operative H&P

jones

Contributor
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I have a new physician that is doing the pre operative H&P for the surgeons at the hospital. If they are Medicare patients she is not able to use the consultation codes. She does not feel that it should be a new patient em level because she may or may not continue with the patient care. Can anyone give me some advise, or point me in the right directions.
 

dclark7

True Blue
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Hartford, CT
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It doesn't matter if she is planning on seeing the patient again, if the patient hasn't been treated by another physcian (of the same specialty) in the group within the past three years then it is a new patient. If the patient is an established patient with your group then she would use the appropriate E/M codes 99211-99215. That being said, what does she want to code these as? Since Medicare won't pay her for a consult the only other codes she can use are the established or new (providing this is not inpatient). Not much choice, so she might as well go for the higher paying (new) code if she is able to.
 
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