new vs established patient

bluemoon1

Guest
Messages
52
Best answers
0
A patient is seen by his doctor within the 3 year period. Can a practice determine that if a patient is not seen for over a year but
less that 3 years that he be coded as a new patient? Thanks much
 

thomas7331

True Blue
Messages
3,140
Best answers
8
No, the 3-year definition for a new patient is stated in CPT. An individual practice cannot change CPT definitions. To bill a patient as new if they were seen by the provider within the last 3 years would be a misrepresentation. There would also be no benefit to doing this because almost all payer claims systems will catch this error and deny the claims.
 
Top