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Billing Question

  1. #1
    Default Billing Question
    Medical Coding Books
    A Patient Comes In For A Procedure But Is New To The Physician Can We Bill For A New Patient Ov As Well As The Procedure If The Physician Does An H/p?

  2. #2
    The CPT book gives the guidelines for billing both an E/M and a Preventive visit on the same date of service under the "Preventive" section. It states that both and E/M & a Preventive Exam can be billed using a (-25) on the E/M if "...problem/abnormality is significant enough to require additional work to perform the key components of a problem-oriented E/M service, then the appropriate Office/Outpatient code 99201-99215 should also be reported." Hope this helps...also, the "AAFP" website has some good articles regarding this same issue.
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

  3. #3
    Oh! Chequita...I'm so sorry, I misread your question; I apologize. It is my understanding that a procedure and a new patient visit can be billed if the e/m is "significantly identifiable" from the procedure by appending either a
    (-25) or a (-57) modifier (depending on the procedure's global days).
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

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