Wiki New patient

[Lainie0559]

Any thoughts? The patient saw the plastic surgeon in the past three years and had cosmetic surgery that was not billed to the insurance. The patient then returns for a medical issue and an office visit is billed. Would you code as a new patient or established?

 

[julieordway]

Bill an established visit code. By definition, CPT defines a new patient is one that has NOT been seen in the last 3 years by them, or another QHP of the same specialty in the same group.