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Well woman w/problem visit

  1. #1
    Question Well woman w/problem visit
    Medical Coding Books
    I am having a problem finding where I have read that when a patient comes in for a (New Patient) well woman exam and also addresses a problem, then the problem visit is billed as an establised patient with a -25 modifier.

    Does anyone know where I can find this information? the CPT book does not clarify this issue for me.

    Any help would be great,

  2. Default
    Not sure where you read it, but that is correct. I work for an OB office and my doctors use 99213-25 with a well woman exam, that also has probem issues

  3. #3
    Thank you Amy. I am currently auditing a physicians office that is coding both as new patient visits, and unfortunately some insurances are paying them. My main issue was that even though it is correct to bill the way you and I have stated, is it also plan driven? or will these insurances come back for refunds?

    Thank you,

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