Has anyone seen the change in E/M for 2012 for New vs. Est patients? This was in the Coding Edge:
Three-year Rule Applies to Same Group, Same Subspecialty
Clarifying the definition of new vs. established patients, CPT® now states, “A new patient is one who has not received any professional services from the physician or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.” This is a restatement of the familiar “three-year rule,” but is significant in allowing a physician to bill a new patient service (e.g., 99202-99205), even if another physician in the group practice has seen the patient within the past three years - as long as the physicians are of a different specialty/subspecialty.
This is a significant change for coding New patients referred within a practice of different subspecialties, i.e., Orthopedics.
Does anyone have experience with this new rule?
Thanks!
Lora
Three-year Rule Applies to Same Group, Same Subspecialty
Clarifying the definition of new vs. established patients, CPT® now states, “A new patient is one who has not received any professional services from the physician or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.” This is a restatement of the familiar “three-year rule,” but is significant in allowing a physician to bill a new patient service (e.g., 99202-99205), even if another physician in the group practice has seen the patient within the past three years - as long as the physicians are of a different specialty/subspecialty.
This is a significant change for coding New patients referred within a practice of different subspecialties, i.e., Orthopedics.
Does anyone have experience with this new rule?
Thanks!
Lora