I work in a pulmonary office, so we do PFTs and ABGs. Due to scheduling reasons, sometimes we have pt come into the office a few days before their initial appoitment to do the PFTs and ABGs. Medicare is now denying our new patient E/M code because they consider code 36600 (artierial puncture) as the first time the doctor sees the patient. They want us to use and established patient E/M code.

I need your opinion on this. The doctor has NO face to face contact with the patient during the ABG puncture, this is done by our respiratory therapist. The results are later reported to the physician. I have tried to appeal this decision to Medicare, but they still stand by their originial decision. Please help???!!!???