My new wound doctor also has his surgery practice still and see's patients in hosp. He then refers them to our wound care instead of seeing them at his practice. Having issues with billing new pt codes, directions? is this kosher? ty
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Wiki Surgeon working for wound care
- Thread starter mjstack
- Start date
AmandaBriggs
Expert
Per CPT, "A new patient is one who has not received any professional services from the physician/qualified health care professional or another physician/qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years." (CPT 2021, p6). If he's billed any face-to-face encounter with the patient within the past 3 years then the patient is established to him.
kseebeck
Networker
Without more information, I would guess that you are having issues billing new patient codes because these patient's are not actually new to this physician even though they might be new to the wound care practice.
SharonCollachi
Guest
My boss doesn't like that he doesn't get to bill a new visit code when he sees someone in the hospital who then follows up in his private practice.
You bill an established patient code.
You bill an established patient code.