Wiki Opthalmoloy E/M codes

[kumeena]

Hi,

I posted Yesterday under Opth fourm. I did not get any response. Please someone answer this question.

Patient was seen by Opthalmologist in 2009 and again he/she was seen by the doctor today (2013).

Is it New or Established patient for hospital to use E/M code from Opthalmology section in CPT book?

Thank you

 

[drakena74]

just to make sure I understand. The patient was seen by your ophthalmologist in the Hospital on both dos? was it inpatient or ER/outpatient on one or both occasions? or was the patient seen in the doctor office in 2009 & 2013?

if office setting then for 2013 dos patient is considered a NEW patient per AMA CPT guidelines.

for hospital, I believe the CPT description stateds for both new & est. pt.

 

[kumeena]

just to make sure I understand. The patient was seen by your ophthalmologist in the Hospital on both dos? was it inpatient or ER/outpatient on one or both occasions? or was the patient seen in the doctor office in 2009 & 2013?

if office setting then for 2013 dos patient is considered a NEW patient per AMA CPT guidelines.

for hospital, I believe the CPT description stateds for both new & est. pt.

Thanks for the reply.

Both times patient was seen in Eye clinic (Out patient). We billed 92004 (Newpatient ) in 2009 and would like to bill 92012 for this time (2013).
But still want to make sure that I am dong right.
I use the same concept which I use for other E/M codes(9920X 9921X) for hospital.
Once patinet had MR# it is always establised regardless of the time frame. No 3 year rule for hospital billing/coding.


Thank you for more feedback

Have a nice day

 

[drakena74]

Thanks for the reply.

Both times patient was seen in Eye clinic (Out patient). We billed 92004 (Newpatient ) in 2009 and would like to bill 92012 for this time (2013).
But still want to make sure that I am dong right.
I use the same concept which I use for other E/M codes(9920X 9921X) for hospital.
Once patinet had MR# it is always establised regardless of the time frame. No 3 year rule for hospital billing/coding.


Thank you for more feedback

Have a nice day

Because it's been over 3 years, this patient is considered a new patient for 2013. so you will bill a 92002.