tci Medicare Compliance & Reimbursement - 2010 Issue 14

Reader Questions: Patient Becomes 'Established' After First Visit

Question: A patient came to our office and saw one neurologist, but when the patient came back for a followup he saw a different neurologist who ended up taking over the patient's case. The two physicians have different provider numbers and tax ID numbers. Their only connection is that they work out of the same hospital and "cover" for one another if one is out of town, which is what happened here. My guess is to use 99201 for the initial encounter and 99231 for the follow-up. Is that correct?Answer: If the encounters occurred in an outpatient setting...

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