So true Laura......
Although CPT Assistant does support both (new), I would check with your individual carriers. I have many that do honor this guideline.
Per CPT Assistant (Oct 1, 2006)
Evaluation and Management
Question: If a preventive medicine service (99381-99397) and an office or other outpatient service (99201-99215) are each provided during the same patient encounter to a new patient, is it appropriate to report each evaluation and management (E/M) service as a new patient visit? Or is it appropriate to report the preventive medicine service as a new patient and the acute visit (ie, office or other outpatient service, 99201-99215) as an established patient?
AMA Comment: It is important to first take careful note of the New and Established Patient instructions provided in the E/M services guidelines of CPT 2006 (page 1). Specifically, the guidelines state:
Solely for the purposes of distinguishing between new and established patients, professional services are those face-to-face services rendered by a physician and reported by a specific CPT code(s). A new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years.
An established patient is one who has received professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years.
Therefore, if a preventive medicine service and an office or other outpatient service are each provided during the same patient encounter, then it is appropriate to report both E/M services as new patient codes (ie, 99381-99387 and 99201-99205, as appropriate), provided the patient meets the requirements of a new patient based upon the previously noted guidelines.
If, however, the acute visit (ie, office or other outpatient service, 99201-99215) is performed on a date subsequent to the new patient preventive medicine service and within 3 years, then it would be appropriate to report the established office or other outpatient visit code (ie, 99211-99215, as appropriate).