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Thread: new vs established patient

  1. #1

    Default new vs established patient

    AAPC: Back to School
    We have a new practioner joining our practice. He is coming from a practice in the same town. I think that because he is changing groups, any of his patients that transfer care to our practice will be treated as new on their first visit. Not all of the coders feel the same? Please help

  2. #2
    Join Date
    Apr 2007
    North Carolina


    If the patient has had a face to face visit within the last 3 years, it will be considered an established patient.

    When you change practices

    Consider this scenario: Suppose you leave the practice where you have been working for a number of years to join a new group in a nearby community. Some of your patients transfer their care to the new practice and see you within three years of their last visits. You would report these encounters using an established patient code because, although you are practicing in a new group, you have provided professional services to the patient during the last three years. Note that whether the patient has transferred his or her medical records to your office and how long you may have had those records is irrelevant. The amount of time that's passed since your last encounter with the patient is the determining factor.


  3. #3
    Join Date
    Apr 2007
    Boston, MA


    Well said Rebecca. I agree with this!
    Karolina, CPC, CPMA, CEMC

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Established ... UNLESS

    Any of his patients that transfer will be considered established patients ... UNLESS it's been more than 3 years since he last saw the patient.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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