• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki 2023 EM new rule for New patients-Clarification needed

Create Wiki
M

MSCALLIE79

Networker
Messages
33
Location
Gastonia, NC
Best answers
0
Hello all,

I am a multi- specialty ophthalmology practice, and have a questions regarding an article we received from North American Neuro-Ophthalmology Society, I am trying to prevent denials, but my physician now have a questions since we have 6 subspecialties but we all bill under 1 Group NPI.
Can we bill a new patient exam under the sub-specialty taxonomy and each sub-specialty receive a new patient exam within the same group NPI?

Dear Members of the North American Neuro-Ophthalmology Society,

We would like to inform you of the new changes to billing E&M visits effective January 1, 2023. The new wording states that established patient visits (E&M 99212-99215) refer to patients seen within a practice by a physician “in the exact same specialty and subspecialty”. This means that a patient seen by a non-neuro-ophthalmologist within the same practice (cornea, glaucoma, retina, etc.) but not by the neuro-ophthalmologist should be billed as a new visit (E&M 99202-99205).
 

Attachments

Those are my understandings of the new vs. established patient assignment criteria. Hopefully, the taxonomy code will differentiate when you file claims so they don't reject based upon them having been seen by another provider in the office.

Tom Cheezum, OD, COPC
 
You must log in or register to reply here.
Top