Wiki New Patient Preventative and E/M on Same Day

[Sandra.mitchell]

Hi, I have a doctor who sees a patient for a new patient preventative visit. While there, the doctor notices the patient has a problem that needs to be treated and treats it during that visit. I know I can bill both the preventative and an E/M service, but I'm not sure if the doctor bills a new preventative visit, if I can bill a new E/M visit, or if the E/M will technically be an established visit.

Thank you for the help!

 

[britbrit852003]

You can bill both on the same day but the preventative will the new visit and the E/M will be an established visit. Also do not forget your modifier 25 on the E/M!
EX: 99385
99213/25

 

[MikeEnos]

Exactly, the routine preventive service is billed using the 'new patient' code depending on their age, and the "problem-oriented" portion of the visit is billed using an established office visit code 99212-99215 (although generally speaking it should be a 99213 or 99214)