Wiki New pt E/M billing after 90791/90792

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Noblesville, IN
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Can a new patient E/M code be billed after the patient has received a 90791/90792 prior to that date of service? I know that E/M codes cannot be billed with a diagnostic evaluation on the same date of service, but what about a new patient E/M being performed by a physician several days or weeks after a 90791/90792 is performed?
 
Can a new patient E/M code be billed after the patient has received a 90791/90792 prior to that date of service? I know that E/M codes cannot be billed with a diagnostic evaluation on the same date of service, but what about a new patient E/M being performed by a physician several days or weeks after a 90791/90792 is performed?

No, you cannot bill a 9920x after a 90791 by the same physician (or a group physician of same specialty), unless three years have elapsed. The definition of a new patient in the CPT book is clear on this.
 
In this case, an HSPP performed the 90791 and an MD performed the new patient E/M several weeks later. They bill under individual NPIs. Would this change the outcome in any way or would the same rule apply?
 
We don't have "HSPP" here; a google search told me it's a psychologist.

First, this only applies if they are in the same group, same tax id, billing under the group NPI for billing entity and their individual NPI for rendering entity. If they aren't in a group together, it won't matter either way as they are not attached to each other.

It appears in your case, a Psychologist performed the 90791 and then the patient saw an MD later. If so, then the MD should be able to bill a new patient visit, as they are different specialties.
 
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