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You Be the Coder: Billing a New Patient

Question: A new physician joined our practice. He is seeing a patient whom he has never seen, but other physicians in the practice have seen the patient. Can the new physician bill a new patient evaluation and management (E/M) code?

New Mexico Subscriber

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Answer: If the physician is in the same practice and is operating under the same group tax identification number (as is usually the case) and works in the same medical specialty (including subspecialties), he or she cannot bill a new patient E/M code.

If another physician in the practice has not seen the patient within the past three years, however, the new physician can bill the new patient visit.

- Published on 2000-06-01

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