I understand the definition of what makes a patient considered new vs established, however I've run into an instance where I'm not sure how to categorize the patient. The patient has been seen multiple times for prenatal care. Those encounters have been billed to the payer with 0502F and we expect to bill the full global pkg after delivery. The question is for a separate problem focused office visit unrelated to the pregnancy. All of our providers are considered family practice, so there is no question about different specialties. I know 0502F is a CPT catII code and not e/m or surgical code, but she has had several face-to-face examinations. I'm likely overthinking it, but both new and established for the office visit feel wrong.
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New vs Established Patient - defining professional services
- Thread starter alstonlaura1@gmail.com
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jkyles
True Blue
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Hi there, check your CPT manual's definition of new and established patients: "... professional services are those face-to-face services rendered by physicians and other qualified health care professionals who may report evaluation and management services." (Emphasis added.) The manual doesn't mention specific types of codes.