amcgowan6
New
If a patient is being seen exactly 3 years to the day from last visit example last seen 02/10/2017 and is seen again 02/10/2020 would this be considered established or new?
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New vs Established
- Thread starter amcgowan6
- Start date
I don't know if there are specific guidelines but I would think it is established, it's still "within" 3 years. If it were 02.11.2020, I would go new all the way.
Here is an article from AAPC (not CMS) on there recommendation.
Here is an article from AAPC (not CMS) on there recommendation.
Pathos
True Blue
At my previous job, we had the exact same question. We asked Noridian (our local MAC) on further guidance, and they just recited the 3 year rule. Our take was that after 3 x 365 = 1095 days, then the patient would be considered "New" on the 1096th day, so on the 02.11.2020 as Brittany is saying. Any time within 1 -> 1095 days, the patient would be considered "Established" assuming the other New vs. Established rules were being followed.
Hope that helps!
Hope that helps!