New patient vs follow up c/ CNP thrown in

[presh180]

Hi everyone! I work for a Neurology Practice with one Physician and a CNP. I understand the 3 year "face to face" rule to distinguish between a new patient vs follow up, however in the E/M guidelines it states "physician in the same practice/specialty". It does not state any other term besides "physician".

So, my question is: If John Doe was seen by our Nurse Practitioner initially and then 2 years later comes back for an unrelated problem and sees the Physician, can we code this as a NP visit?

I think we have to code as a follow up visit since she is in the same Practice/Specialty, but am doubting myself since the CPT guidelines only use the word "Physician".

Any and all help appreciated! Thanks!

 

[Orthocoderpgu]

Since the two practitioners are of the "Same Specialty" it would be a follow up, not a New Patient.

 

[presh180]

That was my thinking too, but the CPT guidelines are so specific with the word "Physician" that you start to doubt yourself!

 

[presh180]

Soooo it would be easier to understand also if the guidelines used the word "Practioner" instead of Physician, right? ;-)

 

[MnTwins29]

CMS has language in various references that includes "non-physician providers." The cynic in me wants to say the AMA won't give credit to anyone who isn't a doctor!