Urology Coding Alert

Hint: Don't focus on the E/M place of service. For every patient your urologist sees for an office visit, your first coding task is to determine if the patient is new or established. Make your job easier by understanding the essential three-year rule. Take a look at what the experts say about when -- and how -- you should apply the infamous three-year criterion. Turn to CPT for Guidance The chief factor in determining whether a patient is new or established is time. You must decide whether your urologist has seen the patient in the past, and if he has, how long ago. Rule: CPT clearly defines what qualifies as an established patient: "An established patient is one who received any professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years." Ask yourself, "Has the patient seen the [...]