• 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 Established vs New PT Conflicting Info

Create Wiki
J

jojoboyer10

Guest
Messages
2
Best answers
0
Receiving conflicting info for the following, can anyone help?

Anesthesiologist administered anesthesia to a surgical patient several years ago under a different practice. Recently, the anesthesiologist began treating the same patient for pain under a different practice. How would the E/M be billed?
 
1. If the bill for the previous procedure went out with a different tax ID than he/she has now, then the patient is new.

2. If the previous encounter was 3 years ago or longer then it is a new patient regardless of the tax ID.

See the New Vs. Established patient flow chart in the CPT book for more info.
 
Established patient if within 3 years

Regardless of whether the anesthesiologist was with a different practice, if face-to-face service was provided within the last 3 years by the same physician or by the same practice the patient is considered established.

So if the anesthesiologist provided service to the patient within the last 3 years, the patient is established.

If the patient was seen by another physician in this practice of the same specialty within the last 3 years, the patient is established.

F Tessa Bartels, CPC, CEMC
 
You must log in or register to reply here.
Top