Maybe I'm misinterpreting your statement, but why do you "have to charge the first visit ... as a level 4"? You code based on the documentation and what that supports ... might be a level 2 or a level 5.
In any case ... new vs established ... Is your childbirth educator a provider who is contracted to bill for Medicaid? If NOT, and no prior bill has been generated, then the first visit with the MD could be considered a new patient visit (no professional services within the same pratice, same specialty for 3 years).
BUT ... If the patient has been seen by any provider in the OB service who is contracted with Medicaid within the last 3 years, then the visits are established patients.
Some physician's offices send out fairly comprehensive history forms to be completed and returned before the first appointment ... the "medical record" has been started, but the patient hasn't been seen yet. The first face-to-face visit with a provider is the "new patient" visit.
F Tessa Bartels, CPC, CPC-E/M
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join