Wiki New problem for established patient

[wynonna]

Good morning fellow coders:
Patient came in with a mass discovered by an MD in our practice one year ago.
Patient was seen yesterday by a different provider in our practice about this same mass.
The problem was new to this provider, (examiner) who had never seen patient.
The patient is established, mass is not new to our practice, but mass is new to our provider.
Does this scenario count under number and complexity of problems addressed as "1 undiagnosed new problem with uncertain prognosis"
Thank you

 

[thomas7331]

Providers in the same practice who are of the same specialty should be treated as if they were the same provider - that is standard across most payers. I would not consider it a new problem unless it was being evaluated for the first time by a different kind of specialist than the one who evaluated it previously.