Pulmonology Coding Alert

Question: We have a new pulmonologist in our group whose patients from his previous group followed him to ours. Some of the staff argues that we should bill these patients' first visits in our clinic as new patient visits. Some believe we should bill them as established. What is the correct way to bill for these first visits in our clinic? California Subscriber Answer: The chief factors to consider when determining whether a patient is new or established are always time and physician. You must decide whether your physician has seen the patient in the past, and if he has, how long ago. These guidelines also apply to a new physician in your practice. How it works: If the new physician in your clinic has provided professional services to a patient elsewhere, such as in a hospital or other practice, within the last 36 months, the patient is an established [...]