Wiki E/M Codes for Group Practices

[BrendaWatkins]

Do I understand correctly that NEW PATIENT E/M services can be billed when an individual in the same group, but a different specialty sees the patient for the first time? More specifically, when a patient has been seen by a physical therapist, can a chiropractor or acupuncturist bill using new patient E/M codes for the professional's first visit with the patient? I understand the requirements and acceptable frequency of billing E/M codes and use of modifier 25.

Thanks in advance for your help.

 

[Orthocoderpgu]

This will depend on credentialing

If a patient is seen by a provider of a different specialty, it is possible to bill for a new patient visit, however you cant do that unless the providers are credentialed differently.

I have two hand specialists. One I can bill a "new patient" visit because he was credentialed as a hand specialist. The second one was just credentialed as an ortho surgeon like everyone else. So with him I cannot bill a new patient office visit due to that.