AAPC - Back to school
Results 1 to 3 of 3

Thread: Established patient question

  1. #1
    Join Date
    Apr 2007
    Lehigh Valley

    Question Established patient question

    AAPC: Back to School
    Hello all,

    I am currently coding an established patient seen by one of our physicians last year for morbid obesity. The patient is seen in reevaluation for the morbid obesity by another physician in our practice this week.

    My question is this, for the MDM under number of diagnosis would the morbid obesity still be est. problem (to examiner); worsening or is this a new problem to this physician?

    Also the patient has comorbidities, however, doctor states them this way "morbid obesity is complicated by obstructive sleep apnea and GERD. He does not state if they are stable or worsening. Could these be counted or not??? I am leaning towards no, but would like other opinions.

    Thanks in advance for your help!


  2. #2
    Join Date
    Apr 2007


    WPSMedicare states that all providers in the same group same specialty are considered the same provider, so they would call this and established problem if the providers are the same specialty. If they are different specialties then it would be a new problem.

    I would code and count the other 2 chronic conditions. They would be considered stable unless otherwise documented.

    Laura, CPC

  3. #3
    Join Date
    Apr 2007
    Lehigh Valley


    Thanks for the help!

Similar Threads

  1. Replies: 7
    Last Post: 05-19-2016, 08:23 PM
  2. new patient vs established patient guidelines in a SNF-please help
    By CTRAVIS in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 03-27-2014, 08:46 AM
  3. Established vs New Patient Question
    By WendyJeann81 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-21-2012, 10:57 AM
  4. Urgent care new patient vs established patient
    By ewheeler in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 01-12-2012, 11:53 AM

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.