Wiki help settle this debate

[perkins05]

Family Practice clinic now has a GYN on staff that they refer patient to. Debated question is can the patient be a new patient when referred to the GYN. They are all under that same tax ID?

Any help will be greatly appreciated!

 

[loribeth15]

Determined by Specialties

It goes according to specialty. If the patient has not seen another Gyn in the last three years then it would be considered a new patient no matter if they seen a family practice with the same tax id.

 

[kumeena]

For facility coding it is Established patient. If it is Physician billing then you go by 3yrs rule. As far as I know there is no 3yrs rule for hospital billing. Once patient established with Medical record # it becomes established from there on.

I would like to here others opinion on this.

 

[broadhim]

since it's 2 different specialties yes, she would be a new patient under the Gyn.

 

[nancyenos]

By CPT definition, a new patient is “one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years.”