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Pediatric Coding Alert

You Be the Coder:

Newborn Checkup

Published on Fri Dec 01, 2000

Question: Should we charge a new or established evaluation and management (E/M) code when a newborn presents to the office for his 2-week checkup and we initially saw him in the hospital when he was born?

South Carolina Subscriber


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Answer: CPT Codes states at the beginning of the E/M services section that a new patient is someone the physician has not seen in the past three years. Therefore, a newborn who was seen in the hospital would not be a new patient, and 99212-99215 (established patient office visits) should be charged.

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