# 99204  vs 99203 Ortho



## montie99 (Feb 18, 2010)

Hello, I would like to know how others would code this scenario.... We are a specialty Orthopedics practice and one of our docs does total knees and hips. He says if a new pt comes to our practice that needs a total joint replacement he can bill a 99204. I was always told as a specialty practice we would not met the criteria for this high of a level (on a new pt) due to It would not be medically necessary to do the full review of symptoms(1997 guidelines). Thanks for any response!!!


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## Walker22 (Feb 18, 2010)

I think you have been informed incorrectly. I work for a specialist and we bill 99204 regularly. I suggest you get a copy of the 1997 E&M Documentation Guidelines and familiarize yourself with the requirements. As long as your documentation supports the service, you can bill it.


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