Oncology & Hematology Coding Alert

Question: We have a new oncologist who is coming over from a nearby county, so of course she has her own patients who will be following her. Should we charge her patients as new, or will they be established because she has seen them? She was practicing and billing under another tax identification and will be changing to ours when she starts. North Carolina Subscriber Answer: If your new oncologist or any other physician of the same specialty has seen the patient within a three-year timeframe, you should count the patient as an established patient (99211-99215), according to AMA guidelines outlined in CPT. If your new oncologist or any other physician of the same specialty in your practice has not provided any professional services to the patient in the past three years, you should consider the patient new (99201-99205).