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New Patient vs Established Patient Code

pvacanti

Networker
Messages
28
Location
Grand Rapids
Best answers
0
We are having a discussion in our office regarding which code should be billed for the following scenario. We performed a surgery (only) on a patient in 2012 we never saw the patient in the office prior to surgery or after the surgery and now the patient comes into the office for an office visit. Do we bill a New Patient code or Established patient code? Thanks!
 

mitchellde

True Blue
Messages
13,306
Location
Columbia, MO
Best answers
0
that is an established patient. Performing surgery constitutes a face to face service, ........ well most surgeries :0
 

crgoldston

Guest
Messages
2
Best answers
0
According to the CPT guidelines, An established patient is one who has received any professional services from the physician/qualified health care professional or another physician of the exact same specialty and subspecialty who belongs to the same group practice within the past three years. This patient received face to face treatment with the time limit making her an "established patient"

C. Goldston (Coding student)
 
Messages
1
Best answers
0
New Patient VS Established

Our group recently merged with another group. We have one MD that had seen a patient from CNA Practice before the merge. The same patient decided to see a different MD after the merge, and that MD was from another group. So wouldn't the patient be considered New to that MD within that new group?
 
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