Professional Services

skeeley

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I have been told that the term "professional services" has been revised. Does anyone know if that is true? I have read that the codes for prolonged services took out "face to face" but I have not heard this to be true of all E/M coding. Our doctors are under the impression that phone calls and refills within the 3 year rule constitute an established patient even if they have not been seen "face to face" in 3 years. Any help would be appreciated. Thanks all.
 

RebeccaWoodward*

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I have been told that the term "professional services" has been revised. Does anyone know if that is true? I have read that the codes for prolonged services took out "face to face" but I have not heard this to be true of all E/M coding. Our doctors are under the impression that phone calls and refills within the 3 year rule constitute an established patient even if they have not been seen "face to face" in 3 years. Any help would be appreciated. Thanks all.
There is a CPT Assistant that supports their view but this has since changed (1999 CPT Assistant). There is a CPT Assistant dated 2004 that supports the change. The changing of view for new versus established was if the patient had received a face-to face professional medical service from the physician.
 

skeeley

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Where could I see the CPT Assistant from 2004? What would "you" do if a patient had not been seen in office for over 3 years but had a refill called in within that time frame? Thank you SO very much.
 

RebeccaWoodward*

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If the patient had not been seen within 3 years (same specialty), I would suggest a new visit; regardless of the refill. Just a side note: Is it good practice for a patient to receive a refill when they haven't been seen 3yrs + ? Probably not...for liability reasons ; but then again, I'm not the provider.

I can fax this information...
 

skeeley

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If anyone could please fax me the CPT Assistant from 2004 regarding face-to-face professional services that is mentioned above I would greatly appreciate it. HUGE debate in our office right now. Thank you so much.
 
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