New vs. Established

thelton

Networker
Local Chapter Officer
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91
Location
Farmington, AR
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I would like some opinions regarding the following scenario:

For new patient office visits, the CPT book defines “professional services” as those face-to-face services rendered by a physician and reported by a specific CPT code”. If a Radiologist performs a face-to-face service, but does not report it, shouldn't that still allow the group to report the patient as a new patient next time a face-to-face service is performed?

Thanks!!
 

mhstrauss

True Blue
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1,241
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Baton Rouge
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I would like some opinions regarding the following scenario:

For new patient office visits, the CPT book defines “professional services” as those face-to-face services rendered by a physician and reported by a specific CPT code”. If a Radiologist performs a face-to-face service, but does not report it, shouldn't that still allow the group to report the patient as a new patient next time a face-to-face service is performed?

Thanks!!
I would say no, based on the next sentence in that paragraph: "A new patient is one who has not received any professional services from the physician or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years." Whether or not the previous service was actually billed out is irrelevant.

Hope this helps!
 
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