# 99401 and New vs. Established Patient



## dballard2004 (Jul 27, 2009)

I have a question that I hope someone canhelp clarify for me.  I think I know the answer to this, but I guess I just need some reasuurance.  

A new patient comes into our clinic and all we perform is preventative counseling, CPT code 99401.  The patient had no symptoms.  I am aware that the CPT book states that code 99401 can be used for either a new or an established patient, but if the patient was new and all we did was the counseling only, code 99401, if the patient returns to us for a sick visit a few weeks later, are they now an establsihed patient?  

Now, I say yes because an E/M service was created on the intial visit, but I have a few coders in my office challenging this.  

Any opinions?  Thanks.


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## mitchellde (Jul 27, 2009)

Why would they challenge this?  The patient was in the office face to face with the physician for services rendered, they are now established.  I could be mistaken but I know of no ruleing that cetain services do not count as to make the patient new for the next encounter.


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## dballard2004 (Jul 27, 2009)

I totally agree with you.  Why would they challenge this?  That is a good question!  I agree that they would be established on the return visit, but I guess the coders are thinking that because the patient had no symptoms, they never "established" care.


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## mitchellde (Jul 27, 2009)

Tell them that preventive counseling is preventive "care", so care has been established.


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## dballard2004 (Jul 27, 2009)

I could not agree with you more!  Thanks again.


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