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Sub-Specialist - Confusion!

  1. Question Sub-Specialist - Confusion!
    Medical Coding Books
    A Joint Reconstruction Specialist recently joined our orthopaedic practice. There are conflicting opinions of how to bill for his E/M's. Please help!!!

    An established pt of the practice makes an appt to see the new JRS for possible joint reconstruction surgery... Should the JRS bill as a New Pt Visit? Or bill established pt visits?

    What if the visit was not intended for a joint reconstruction evaluation?

    Thank you!!!!!!!!!

  2. #2
    Milwaukee WI
    Default Established patient
    Unless the "subspecialty" is recognized with it's own taxonomy code by CMS you have an established patient, because it would be the same practice, same specialty.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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