Need health and medical help with AH213 Week 2 Discussion

Dec 7th, 2015
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Question description

Service Codes & New Vs. Established Patient Coding

There are two questions to this discussion; answer both questions.

  1. Place of service codes are required in box 24b of the CMS 1500 claim form. 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 why answer. When you respond to your fellow students’ posts, do you agree with their examples and why or why not?
  2. 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.

New Patient Office Visit Code

Fee

Established Patient Office Visit Code

Fee

99201

$50

99211

$40

99202

$60

99212

$50

99203

$ 70

99213

$60

99204

$80

99214

$70

99205

$90

99215

$80


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)? 

Do you agree with your fellow students’ posts? Why or why not?

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