Wiki New Patient Establishment

[LMOuellette]

Hello and Good Afternoon,
I am looking for different takes on how to proceed with patient establishing with practice. Patient has no medical issues. Patient wants his Annual done, however the practice frowns on doing new patient and AWE done in same visit. What are some ICD 10 codes that can be used. I have a few in mind. Thank you

 

[thomas7331]

This question is frequently asked on the forum so you might do a search through some old threads for ideas.

My opinion on this has always been that 'establishing' with a practice is not a medically necessary reason to bill for any services unless the patient presents at the encounter with a medical problem or a request for a preventive physical or other service. If a provider insists on seeing a patient in order for them to become 'established' with the practice, and the patient neither requests nor requires any medical services at that time, then I would consider this to be a visit done solely for provider convenience and should be offered at no charge to the patient or their insurance plan.

 

[Orthocoderpgu]

"Patient has no medical issues" right there you have just eliminated billing 99202-99205 since there is no medical necessity. I totally agree with Thomas, if you want to do an E/M as a "welcome to the clinic" which is done normally just to establish baselines, there is no medical necessity and nothing that can be billed to insurance.