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Wiki new patient E/M

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rleif1sun

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Monroe, NY
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i'm working for multi specialty health center. we billed 99203 for new patient to dermatology. few months later patient is seen with urgent care as new patient as well and billed 99203 as well. oxford denies 99203 that can't be billed within 3 years of another 99203 even different specialties. is that true?
 
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Hi RLeif1sun,
Yes if patient seen at same medical center with same tax ID #....this is not considered a new patient on 2nd time visiting. The departments are different (urgent care vs dermatology clinic) but all managed by same entity even though departments and doctors are different. Insurance payers track this data for first time patients seen at different office visits by same medical center. If patient has not been seeking treatment for 3 years or more when come back can use new CPT code.
I hope this helps you
Lady T:)
 
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