Charging for a new patient physical along with a new patient office vist

If a new patient comes in for a physical, but presents with multiple existing issues, can you charge out both the new patient physical and the new patient E/M?

re: Charging for a new patient physical along with a new patient office vist

Regarding billing a physical and problem-oriented E/M visit, the April 2011 issue of Coding Edge from the AAPC quotes, "Do not bill both services together regardless of the insurance because the history and exam elements overlap and documentation can only be counted once." Granted the article was discussing the AWV which became available to Medicare beneficiaries in 2011, but the information does specify..."regardless of insurance." The article goes on to say, "Both the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services state, 'a review of all three history areas is required for services that by their nature include a comprehensive assessment or reassessment of the patient.' New patients fit in this category. The IPPE and AWV (and a New Patient Physical, for that matter) also require patient past medical, family and/or social history. Counting work done once for two billed services is 'double dipping' ". (Source: AAPC "Coding Edge" April 2011)

Hope this helps you out!

re: Charging for a new patient physical along with a new patient office vist

What about billing the new patient PE with a 99214 25 (est pt).? this is what we've been told to do in the past but it just seems that all that work is already built into the new patient physical. Thanks