Advanced Search

Otolaryngology Coding Alert

Reader Question:

Billing New Patient Visit

Published on Sat Apr 01, 2000

uestion: A new physician joined our practice. He is seeing a patient that 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

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, says Ann Hughes, a coding specialist with Mid-Vermont ENT in Rutland, Vt. 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.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Otolaryngology Coding Alert

View All