AAPC - Back to school
Results 1 to 3 of 3

Thread: New Problem vs Est. Problem

  1. #1

    Cool New Problem vs Est. Problem

    AAPC: Back to School
    I know the rules that clarify a new patient vs a established patient but, if you have a new patient that carries a diagnosis of HTN or DM and the physician is seeing them for the first time as a new patient are the established problems that the patient has previously been diagnosed with considerd new problems to the new physian that they are now seeing?

  2. #2


    Yes. That portion of the MDM is provider driven, not patient driven. These are new problems to the examining provider, so you would either assign 3 points or 4 points depending if any additional workup was done.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  3. #3
    Join Date
    Apr 2007
    North Carolina


    Although I personally agree with Dawson, some carriers do not allow credit for this. I would encourage you to check with your carrier(s).

Similar Threads

  1. Est. problem vs. New Problem
    By torih@nwurology.com in forum E/M
    Replies: 3
    Last Post: 10-14-2016, 08:23 PM
  2. New vs. est problem
    By VRMoran in forum Auditing General Discussion
    Replies: 3
    Last Post: 10-14-2016, 08:20 PM
  3. est. verses new problem
    By Kristene in forum E/M
    Replies: 3
    Last Post: 10-10-2014, 12:54 PM
  4. Replies: 1
    Last Post: 01-23-2014, 08:41 AM
  5. New problem or est. prob
    By Love Coding! in forum E/M
    Replies: 6
    Last Post: 12-31-2008, 09:30 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.