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Thread: new vs est

  1. #1

    Question new vs est

    AAPC: Back to School

    Here's the scenerio-please help!!

    Patient is seen in the ER for a work injury and is NOT seen by one of our providers even though we do do billing for the hospital (just not ER). A week later, the patient follows up with an outpatient clinic we do billing for as well and IS seen by one of our providers. The hospital and clinic share the same tax id#. Would this patient be considered new or established?

  2. #2
    Join Date
    Apr 2007


    New, as long as they are credentialed as different specialties.

    Laura, CPC, CEMC

  3. #3
    Join Date
    Apr 2007
    San Antonio, Tx


    The only way "around" the New Patient rule by physicians within the same group/practice is if the "new" Dr has a subspecialty that is different from the 1st Dr. that saw the patient.
    Ray Galvez CPC

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