New VS Established Office Visits

Each week, you will be asked to respond to the prompt or prompts in the discussion forum. Your initial post should at least 150 words in length, and is due on Sunday. By Tuesday, you should respond to two additional posts from your peers.

Place of service codes are required in box 24b of the CMS 1500 claim form. The place of service codes can be found as the first page of your CPT Coding Manual. What place of service surprises you the most when you think of CPT services being provided at that particular place of service? What place of service surprises you the most when you think that CPT services and procedures are done there and why? Give an example of a claim where this would be important to support your answer. When you respond to your fellow students’ posts, do you agree with their examples? Why or why not?

Take a look at office visit codes for new patients 99201- 99205 and established visits 99211-99215. The new patient visit codes are reimbursed at a higher rate than the established. For example, consider the following codes and fees.

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New Patient
Office Visit Code  FeeEstablished Patient
Office Visit CodeFee  99201$5099211$4099202$6099212$5099203$7099213$6099204$8099214$7099205$10099215$90

Why do you think new patient codes get higher reimbursement than established patient codes (for example a 99202 office visit codes reimburses higher than its counterpart 99212)?

When you respond to your fellow students’ posts, do you agree with their explanation? Why or why not?

 
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