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diagnosis points

  1. #1
    Default diagnosis points
    Medical Coding Books
    A question came up and I wanted to get some other opinions on this.
    If an established patient comes into the office and sees a different provider in the same group/speciality for a follow up of a established condition, would you consider the problem to be a new problem to the examiner or an established problem?

    Thanks

  2. #2
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    Baton Rouge
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    Quote Originally Posted by chasarmil View Post
    A question came up and I wanted to get some other opinions on this.
    If an established patient comes into the office and sees a different provider in the same group/speciality for a follow up of a established condition, would you consider the problem to be a new problem to the examiner or an established problem?

    Thanks
    New problem to the examiner. Just one more thing to cause confusion against the "new patient vs established patient" guidelines
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  3. #3
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    New Patient: hasn't seen a Dr in 3 years (not the; same speciality, subspecialty, or group).
    Established Patient: has been seen in 3 years (same specialty, subspecialty, and group)

  4. #4
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    Daytona Beach, FL
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    If that provider has not seen the patient for the diagnosis, then it would be a "new problem" (not "new patient") to that examiner so that they could get the extra credit under the # of Diagnosis/Treatment Options area. However, I would educate the doctors to make a notation in their note that this is a new problem to them!
    Jodi Dibble, CPC

  5. #5
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    Related question:

    The provider saw the patient for this problem on the last visit, but did not know what it is, so did a biopsy. Now that the path is back, the next visit has a new diagnosis code based on the path report. Is this a "new diagnosis"?

  6. #6
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    I would say no, this is not a new problem. Since the doctor already saw the patient for this issue and had work-up done to verify a diagnosis, then it is still the same problem - it just has a name now! :-)
    Jodi Dibble, CPC

  7. #7
    Location
    Baton Rouge
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    Quote Originally Posted by jdibble View Post
    I would say no, this is not a new problem. Since the doctor already saw the patient for this issue and had work-up done to verify a diagnosis, then it is still the same problem - it just has a name now! :-)
    I agree with Jodi...same problem, just now has a more definitive diagnosis!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

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