new pt versus EP patient

heart123

Expert
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302
Location
Spring, TX
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If a doctor in the same practice same tax id # sees at pt in the hospital and then the pt comes to the office and sees a different doctor
would this be a new patient
 

heart123

Expert
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302
Location
Spring, TX
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Even if it was a hospital pt that was seen first ?? sorry I'm not doubting but, my manager is saying it can be billed as a new pt because he was not seen in the office and was seen in the hospital first but,
from the way i was taught and how I've always billed
once a doctor see you, touches you if its the same group its not a np but ep
is there any verbiage i can show them that states this.
I know in looking up new pt it states this but there saying because of the hospital visit first and they have never been in the office its new
thanks so much
 

sglamuzina

Contributor
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19
Location
Garden Grove, CA
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EP has a seperate speciality code from Cardiology but when the EP and the Cardiologist are in the same practice is becomes a little complicated because of the TIN relation. I have had success when my EP is seeing a patient after the Cardiologist using AF Modifier soley for Medicare but PPO carriers are not as easy.

Biggest Tip: Make sure the specialities are seperate and updated with the contracts.

 
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