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Thread: E/m new pt vs estab

  1. #1
    Join Date
    Apr 2007

    Default E/m new pt vs estab

    AAPC: Back to School
    Dexa and E/M charged by the same physican different date of service.
    Can you charge a new patient visit for the E/M - it was performed after the dexa? The physician never physically saw the pt for the dexa. He only interpreted the dexa.

    Kathy, C.P.C

  2. #2
    Join Date
    Apr 2007
    Kansas City, MO


    For Medicare yes. They use the term "face-to-face". If no face-to-face visit in the past three years, you can charge a new patient visit. Most other insurances will follow this.

    However....CPT uses the term "professional services"..so no guarantee. I'd bill as new.

  3. #3
    Join Date
    Apr 2007


    It was billed as New. Medicare paid however Cigna is requesting it be changed to established. Thank you for the response.

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