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New Problem vs Est. Problem

  1. Cool New Problem vs Est. Problem
    Medical Coding Books
    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
    Overland Park, KS
    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, CRHC, AAPC Fellow

  3. #3
    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).
    Rebecca CPC, CPMA, CEMC

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