tci E/M Coding Alert - 2018 Issue 4

Reader Question: Code for Incident-To Service for Established Patient Only

Question: Can you report 99211 for new patients? Illinois Subscriber Answer: No, you cannot bill 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional ...) in this situation. "Use of 99211 is strictly for established patients - never a new patient since there must be a plan of care with the plan documenting a brief follow-up E/M encounter," says Catherine Brink, BS, CMM, CPC, president of Healthcare Resource Management in Spring Lake, New Jersey. "This follow-up E/M...

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