Wiki NEW VS ESTABLISHED PATIENT - PROFESSIONAL SERVICES

[trkrgal73]

Hello - In the CPT book it states: Solely for the purposes of distinguishing between "new" and "established" patients, "professional services" are those face-to-face services rendered by physicians and other qualified healthcare professionals who may report evaluation and management services reported by a specific CPT code(s).

My question is what is included in "professional services?" Are "professional services" only E&M codes (office visits, etc.)? Or can they include surgical procedures? Such as, would a colonoscopy be considered a "professional service?"

Thanks so much!

 

[thomas7331]

Professional services are any services that involve a face-to-face interaction with the patient, so this does include surgeries. If the provider has performed a surgery on the patient within 3 years, that patient is established. Non-face-to-face services, such as x-rays or other diagnostic tests that do not involve any direct contact between the patient and provider, do not establish the patient to that provider.

 

[trkrgal73]

Professional services are any services that involve a face-to-face interaction with the patient, so this does include surgeries. If the provider has performed a surgery on the patient within 3 years, that patient is established. Non-face-to-face services, such as x-rays or other diagnostic tests that do not involve any direct contact between the patient and provider, do not establish the patient to that provider.

Thanks so much for confirming this! I was advised it was only E&M services, but begged to differ, and was thinking the same as what you have stated above. - Thanks again!