Wiki Established Pt Last Seen in 2011

Diana2032

Networker
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Succasunna, New Jersey
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Good afternoon All,

My provider last treated a Right Knee injury on a pt back in 2011 (5 years ago). He did an arthroscopy procedure and the pt did well after that. 5 Years later the pt is coming back complaining of pain in the Right Knee. I'm billing this as a new pt visit because it's been over 3 years but how about under the Medical Decision Making table, would this be considered a WORSENING problem since it's the same knee, or would it be considered a NEW problem? Please advise.

Thank you so much!!
 
I would use new problem for a new patient. I think the patient becomes a "clean slate" after 3 years which is why you can bill a new patient code again.

That's my two cents worth, anyway...
 
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