Gastroenterology Coding Alert

Question: We hired a new physician for our practice after another physician left. The new physician thinks he should be able to bill 99205 since the patients are new to him. The patients, however, are not new to the practice. Due to the visits' complexity and since the encounters are follow-ups within the same practice, should these services be 99215? North Dakota Subscriber Answer: Generally speaking, this is not a new patient scenario, and 99201-99205 (Office or other outpatient visit  for the evaluation and management of a new patient ...) is not appropriate. "New patient" means a patient who has not received any professional services, such as an E/M service or other face-to-face service (like a surgical procedure) from the physician or physician group practice -- with the same physician specialty -- within the past three years. If a professional component of a previous procedure is billed in a three year period, [...]