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Thread: New pt help

  1. #1

    Default New pt help

    AAPC: Back to School
    We saw a patient in our group practice the other day and the doctor wants to bill a new patient since we have seen the patient in our office since 2003. The problem is that one of our doctors saw the patient in the hopsital a year ago. Can we bill a new patient since it is two different facilities? When we billed the hospital charge we used our group tax id number but the facility was listed as the hospital. Thank You for any help in this matter.

    Heather Clark CPC
    Juneau, Alaska

  2. #2
    Join Date
    Apr 2007


    If the doctor that saw the patient in the hospital is of the same specialty in that group, then the patient isn't new. It doesn't matter if they were seen in the hospital or in the office within the 3 years by someone in the group.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

  3. #3
    Join Date
    Apr 2007

    Default Yes Pam is right

    Yes--Pam is correct. The CPT book (page 2) defines an established patient as "anyone who has recieved any professional service from a physician in a group of the same specialty within the past 3 years". You would have to code that visit as an established patient visit.
    Hope this helps!
    Carrie, BS, CPC

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