Forum - Questions & Answers

Aug 1st, 2016 - mbrigham 1 

GI specialty office, patient seen with in 3 years but new problem

Since we cannot bill a consult code to some insurances, how can we get a new patient visit when the patient is being seen with in 3 years for a different problem? An upper GI problem and not a lower problem. Our providers are concerned and I agree with them but I want to make sure we can bill this in some manner to get more for them since they are doing basically a consult, since the patient was referred for our opinion on the new problem. Is there a modifier to put on a new patient code?

Aug 1st, 2016 - lkoolsone 11 

re: GI specialty office, patient seen with in 3 years but new problem

You can't bill a new patient E/M code, you have to use a consult code if patient was sent to you by another dr for a consult visit, or use the established patient codes for follow up visit.



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