Wiki New Patient Visit

[staticsis2]

We are asked to see a patient at the hospital which is 99222-99223 later the patient comes to the office as a NEW PATIENT. Since the patient was never seen in our office can we bill a 99201-99205?

Thank you all for your input in advance

 

[jromeyn]

I think you have to bill as an existing patient. The CPT book states if the patient has received any professional services from the physician, it does not distinguish a location.

 

[mitchellde]

It is an established patient even if the patient has never been in the physical office location, they have received face to face service from your provider with in the last 3 years.

 

[Kisalyn]

Any professional services makes the patient established until three years have lapsed.

If you have the AMA CPT 2014 book, there's a nice decision tree on page 5.

 

[staticsis2]

Yeah it can be confusing because we have never billed the patient in the hospital as a "New Patient" but were asked to consult -therefore; it seems as though when patient comes to the office we could have billed a "new patient" e&m code 99201-99205