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New problem to examiner

  1. #1
    Default New problem to examiner
    Medical Coding Books
    Ok if you have a patient that was seen by Dr. X last week for Bronchitus and sees Dr. Y this week same problem. Patient still has it....Dr. Y and Dr. X work in the same practice would you consider this an established problem to the examiner or a new problem to the examiner?

  2. #2
    Per CMS if they are same group/same specialty they are the same provider, ie it would be an established problem. If they were different specialties, ie one was urgent care the other internal medicine, then it would be a new problem to the examiner.

    I don't personally agree with this and I don't know what other carriers take on it is.

    Laura, CPC, CEMC

  3. #3
    Thanks for the help Laura.

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