Wiki Established Patient?

[Partha]

A patient had an episode of hospital admission & discharge recently. Patient is now seen in the office by the same provider or another provider from the same group. Is the office visit considered a new patient or established patient?

Simple questions often throw us out of gear!

Any inputs will be greatly appreciated.

Thanks!!!

 

[LTibbetts]

I, personally, would say "established" but only because the wording in the CPT book states:

"...a patient who has received any professional services by that physician in the last 3 years."

So I would say that a hospital admit would count as a professional service.
On another note, if you look at the decision tree on page 5 of the 2010 CPT book, it also may depend on whether the patient is being seen for the same specialty or subspecialty, but I am assuming, for this case, that the patient is probably following up after the initial hospital visit, but that is only an assumtion.


Anyone else??

 

[Jagadish]

We have to bill the current encounter as established patient service.