decisionhealth Newsletters, Part B News - 2020 Issue 6 (June)
Patients who get a COVID-19 test, and nothing more, stay ‘new’ for next visit
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Article Overview
This short coding article addresses patient status for evaluation and management billing in the context of COVID-19 testing workflows. It focuses on the distinction between testing-only encounters and encounters that involve professional services, helping coders and billing staff understand how those circumstances affect whether a later visit may be treated as new or established. The discussion is aimed at clinic administrators, coders, billers, and coding educators working with office-based testing and follow-up visits.
Why This Topic Matters
Determining patient status correctly is important for accurate E/M reporting and consistent billing practices when testing encounters are followed by result visits or provider evaluation.
What You Will Learn
- How patient status is determined for E/M billing purposes
- How testing-only encounters differ from professional services
- Why follow-up visits after testing can affect patient classification
- How COVID-19 testing workflows intersect with billing status questions
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance staff
- Coding educators
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