New versus Est.

NESmith

Expert
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308
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0
I have a provider who saw a patient for a Workman's Comp injury and billed a New patient visit. The patient came back a month later but now has an injury that is not Workman's Comp related and the provider is billing a New patient visit to their Medicare. Is this correct? I was told that it is different when the initial visit was work related and the second visit is not. I can not find anything to prove this. Please help and as always Thanks for the help.
 

svradenburgh

Guest
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9
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Chattanooga, TN
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It has always been my understanding that there are no exceptions to the new patient requirements for Medicare billing, if the patient has been seen by a provider within that practice within the past 3 years they are not new. I haven't found anything stating otherwise. If you do find something different please post it because that would be great info to have. :)
 
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7
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That's correct. If the patient was seen in the office in the past 3 years, a new patient 99201-99205 can not be billed.
 
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