Otolaryngology Coding Alert
Reader Questions:
Remember the ''Established'' Timeline
Published on Thu Jul 16, 2015
Question: A patient was referred to our practice in 2013 because of otitis media, and was seen by Dr. Smith. She was referred back to us in 2015 for tonsillitis, and saw Dr. Jones. I think we should consider her an established patient but am getting some resistance from my providers. What is correct?
Georgia Subscriber
Answer: A patient is considered to be “established” if your providers within the same tax ID have seen her within the last three years. As long as both physicians who treated her are in the same group and same specialty, code her care as an established patient.
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