tci Part B Insider - 2010 Issue 35

E/M Coding: Knock Out Questions on New/Established Patient E/M

Remember, what used to be a consultation is now likely a CPT 99201 -99215 service.Suppose the physician provides a new patient with a standard office-visit E/M. You mistakenly use an established patient E/M to code the encounter. No big deal, right? Wrong -- Not only is the coding incorrect, but this mistake will cost your practice deserved reimbursement. Further, Medicare's deletion of consultation codes means that coders will have to answer the new vs. established question more often than before.For Medicare payers, and payers that follow their lead, coders now have to select the correct code, new...

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