Wiki E/m new pt vs estab

[kleger]

Dexa and E/M charged by the same physican different date of service.
Can you charge a new patient visit for the E/M - it was performed after the dexa? The physician never physically saw the pt for the dexa. He only interpreted the dexa.

Kathy, C.P.C

 

[LindaEV]

For Medicare yes. They use the term "face-to-face". If no face-to-face visit in the past three years, you can charge a new patient visit. Most other insurances will follow this.

However....CPT uses the term "professional services"..so no guarantee. I'd bill as new.

 

[kleger]

It was billed as New. Medicare paid however Cigna is requesting it be changed to established. Thank you for the response.