tci General Surgery Coding Alert - 2004 Issue 7

Reader Question: Use 99201-99205 if Patient Switches to Your Office

Question: When my surgeon covers for another local private-practice physician, I code the office visits as established patient E/M services. If, a couple of weeks later, a patient decides to switch to my surgeon permanently, should I report a new or an established patient office visit? This visit will require all necessary new patient paperwork.Tennessee Subscriber Answer: You should report a new patient office visit code (99201-99205) for your surgeon's E/M service.As a covering physician, your surgeon temporarily replaces the patient's regular physician, and the regular physician reports the service to the insurer, so by Medicare standards...

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