New Patient vs Established for PA who changed jobs/specialty


Aberdeen, SD
Best answers
We are a dermatology office our PA saw a patient who was new to our office, we billed Medicare a new patient E&M, Medicare denied the new patient visit stating that the PA saw the patient at her previous employer a family practice clinic. Medicare states that it didn't matter that we are a complete different clinic and specialty with different group NPI and tax id, because she is still a "PA" that is her specialty. Has anyone else had this issue? Should I change to an established patient visit and re-file, or appeal on the grounds that we are a different specialty and office? Thanks
NP vs EP

In this instance that visit should be filed as an established patient. You can only bill NP if patient has not been seen by any of the providers within 3 years regardless if they came from different office.
Specialty and subspecialty only come into play if its a different provider under the same TIN. They are established to the individual provider where ever they go and no matter what specialty they practice under if its been 3 years or less.