obgyncoder
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new to coding obgyn....can you code a 99203 with a 99386? two new pt. appt.s together with a modifier -25? I was told we could but it doesn't sound right to me.
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Wiki new pt/preventative coding
- Thread starter obgyncoder
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hewitt
Expert
You can, but you must be sure that there is proper documentation as to why the 99203 is billed/coded. Modifier 25 signifies that there is a "significantly, separate evaluation and management service" being provided. So, if the patient has an additional problem for the doctor to evaluate, s/he must show work done via a separate exam and MDM in the medical note. Remember, preventive medicine services are not to handle a significant problem, but to assess the "wellness" of the patient. 
Take a look in your CPT Book at page 34 (Professional Edition) at the parenthetical note just before the preventive medicine codes.
Take a look in your CPT Book at page 34 (Professional Edition) at the parenthetical note just before the preventive medicine codes.owenstonya
Networker
If the patient is new and came in for the annual I would code the 99386 as the "new pt" visit and since you have tech. established care with this patient you would need to make the E/M an est. visit code for the significantly seperate discussion/treatment 99213 mod. 25...
TYSON1234
Guru
Depends on the insurance company. I did that once, and they only paid for the office visit and not their annual gynecological exam.