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Thread: Diagnositc Test Ordered can we bill new patient E/M

  1. #1
    Join Date
    Apr 2007

    Default Diagnositc Test Ordered can we bill new patient E/M

    AAPC: Back to School
    One of our Cardiologist is ordering nuclear stress tests for patients that have been referred to him as a consult. Medicare is not longer recognizing the consultation codes so he is trying to bill them as new patients. He has not treated the patient face to face but he did order a stress test based on the diagnosis of the treating physician. Can he bill a new patient visit or does he have to bill as an established visit. I researched some of the guidelines and did find information regarding E/M codes but I could not find anything on procedures. A reference link would be helpful.

  2. #2
    Join Date
    Apr 2007
    Bangor, Maine


    Unless he has seen the patient before (or anyone else in the practice), then he can bill the new office visit.
    Below is a great algorith that has helped me immensely with the new consult rules. check it out:


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