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!!!