New Patient vs. established

elenax

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A patient was seen at the hospital for a consult with Dr. 'A' and the next day had injections with Dr. 'A' also at the hospital; then on 5/24/16 the same patient was seen by Dr. 'B' from the same group at the office for the first time. Is the encounter of 5/24/16 considered a New patient visit or an Established patient follow up visit?
 

Walker22

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A patient was seen at the hospital for a consult with Dr. 'A' and the next day had injections with Dr. 'A' also at the hospital; then on 5/24/16 the same patient was seen by Dr. 'B' from the same group at the office for the first time. Is the encounter of 5/24/16 considered a New patient visit or an Established patient follow up visit?

If Dr. B is the same specialty as Dr. A, then the patient is established.
 

CodingKing

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Sometimes I think AAPC needs to do a "Back to Basics" series.

If you review your CPT manual there is a really good decision tree as to whether patient is established or new.

If the provider is the same specialty and subspecialty in the last 3 years in same group practice its established patient.
 
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Patient will be consider established for both the facility and the provider since it was seen by the same specialty.


A patient was seen at the hospital for a consult with Dr. 'A' and the next day had injections with Dr. 'A' also at the hospital; then on 5/24/16 the same patient was seen by Dr. 'B' from the same group at the office for the first time. Is the encounter of 5/24/16 considered a New patient visit or an Established patient follow up visit?
 
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