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Wiki New patient vs. established patient

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andrea1415

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Hi All,
Two MD's at the practice are retiring and many of the patients are opting to establish with the other doctors within the practice. These physicians do not bill under a group TIN as they are all private practice. Since these patients have been seen by a physician in the office within the past three years it is my understanding that a new patient E&M code cannot be used for the first visit with the new MD. Please correct me if I'm wrong. Thank you!
 
Straight from the CPT code book. "A new patient is one who has not received any professional services from the physician/qualified health care professional or another physician/qualified health professional of the exact same specialty and subspecialty who belongs to the same group practice within the past three years." There is also a decision tree in the code book to help you out.

I hope this helps you! :)
 
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