Results 1 to 3 of 3

New Pt physical billed with a new Pt office visit

  1. #1
    Angry New Pt physical billed with a new Pt office visit
    Medical Coding Books
    Can anyone tell me the guidlines for billing a new pt physical with a new pt office visit. I was always taught this was not allowed. That is is either one or the other. The compliance dept where I work is telling the Drs that this can be done. I haven't seen any claims paid for these. Please HELP ME!!!

    Heather in Ma.

  2. #2
    Phoenix, AZ
    It can be done as long as there is enough documentation to support an E/M level AND the documentation for the physical. Usually, the problem portion is a lower level E/M. If you find a mod/high level of documentation, take another look at it. Don't forget to use a modifier for the E/M.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  3. #3
    Agree with Cyndi - it can be done but difficult to carve out because you have still have to meet the requirements for the new patient exam in all 3 areas (history, exam and MDM) in addition to supporting a comprehensive preventive code - documentation needs to be good and you probably won't get a high level E/M in addition to the preventive when they are new and their intent was for preventive service.

    It all comes back to how it was documented. So your compliance department is technically correct IF documentation supports - that is the key.

    Hope that helps!
    Christie Musser, CPC

Similar Threads

  1. Office visit vs physical
    By TIFFANYC in forum E/M
    Replies: 0
    Last Post: 04-29-2014, 09:42 AM
  2. Allergy shots billed with office visit?
    By greatbiller in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 04-02-2014, 02:26 PM
  3. Physical w/ office visit
    By in forum E/M
    Replies: 2
    Last Post: 04-02-2013, 01:46 PM
  4. can an office visit be billed w/a hysteroscopy that is done in the office?
    By COG in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 11-08-2012, 12:35 PM
  5. Annual preventative billed with office visit
    By jogarzusa73 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-21-2012, 01:45 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.