Reader Questions: Beware of Assigning E/M in This New Patient Encounter

Why This Topic Matters

Misidentifying the service type for a new patient encounter can lead to inappropriate claims, denied payment, or inaccurate reporting. This topic is especially relevant for practices that frequently see children for initial visits and need to distinguish administrative intake from billable evaluation or preventive services.

Article Sections

1. Question

   The reader’s scenario is presented, focusing on a healthy new pediatric patient coming to establish care. The question frames the billing issue for an initial encounter with no apparent illness or complaint.

2. Answer

   The response explains the broad billing considerations for a new-patient visit when no condition is being evaluated. It also outlines the general alternatives discussed for intake-only encounters versus a preventive medicine visit.