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can you use 2 new pt codes at same visit?

  1. #1
    Default can you use 2 new pt codes at same visit?
    Medical Coding Books
    Hi! Need help with this senerio...A new patient comes in for a physical and the physician performs an EM at the same visit.
    Do you code the physical as new and the EM as established or do you code both as new? Not sure if you can use 2 new patient codes at the same visit.
    Anyone know the answer to this one?
    thanks Tina

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default Check the forums
    There have been several questions about this in the past. Check the E/M and Family Practice forums to be sure.

    My opinion, is you code both visits as new patient (one preventive, and one sick visit).

    BUT ... in practice this is VERY hard to carve out. You will have to have a complete documentation for the new patient sick visit that is competely separate (and not duplicated) in the preventive visit.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Default
    we do not code two new. How can you be new twice? Your first visit would be new and the second E and M would be return as if the patient left and returned for another visit . You are trying to support two different visit so if in fact the patient left and came back they are not new again

  4. #4
    Smile 2 new visits
    I agree. Bill your pe w/new code as that is worth more money and bill the sick visit with an established code.

  5. #5
    Default
    Thanks for your input but I did find out last night during a chapter meeting the correct answer is you would code both as new.
    Of course documentation must support the additional EM code and in our case it did.
    So the correct answer is both the physical and additional EM (mod 25 added) would be coded with new patient codes.
    thanks again for your thoughts
    Tina

  6. #6
    Location
    North Carolina
    Posts
    3,126
    Default
    That is correct. CPT instructs you to select the appropriate E/M code (99201-99215) for a problem addressed during a preventative exam. There is also a CPT Assistant that supports a new patient E/M along with a new patient preventative.

  7. #7
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Two new may be the correct answer from CPT's point of view, and ours...but good luck getting paid for two new...We code new PE and established E/M.
    Lisa Bledsoe, CPC, CPMA

  8. #8
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    I would code using both the new patient preventative E/M code and the new patient E/M code. Here is my logic....the defintion of a new patient in the CPT manual states being seen by the provider within three years. If the patient presented for a physicial and truly met the defintion of a new patient, then three years did not go by before next E/M service. So both new patient codes should be used.

    Just my opinion.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  9. Default
    I would agree with Lisa, no way are you getting two new visits paid.

  10. #10
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by kimberlina25 View Post
    I would agree with Lisa, no way are you getting two new visits paid.
    That is NOT correct. We DO have carriers that honor both. It clearly states it within their guidelines.

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