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New Patient

  1. #1
    Default New Patient
    Medical Coding Books
    We are having a disagreement here about what constitutes a new patient. We have a new physician starting here and he is bringing 80 patients from his old practice that he has seen within the last 3 years. My interpretation of CPT is that these would be established visits, not New Patients. Some others disagree. What do you think.

  2. #2
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    In CPT book 1st page of E/M guidlines under new and established patient states that a new pt is one who has not received any professoinal services from the physician or another physician of the same speciality who belongs to the same group practice, within the past 3 years.
    So since the doc is coming to a new practice it shouldn't matter they are NEW.
    Nichole

  3. #3
    Location
    Greensboro, NC
    Posts
    67
    Default
    I have also read that they are not new patients to the physician, even though he has changed locations, so they would still be established patients, because they are not new to him.

  4. #4
    Default
    Quote Originally Posted by plugger10 View Post
    We are having a disagreement here about what constitutes a new patient. We have a new physician starting here and he is bringing 80 patients from his old practice that he has seen within the last 3 years. My interpretation of CPT is that these would be established visits, not New Patients. Some others disagree. What do you think.
    I believe the pt is considered established since he/she is seeing the same physician, just because he isn't with the same practice doesn't make the pt "new".


    I think of it like this if this physician would keep jumping from practice to practice and his pt's follow him you wouldn't bill a new pt visit everytime the doc changed employment.



    Just my opinion
    Last edited by rthames052006; 04-04-2008 at 01:32 PM. Reason: added more
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  5. #5
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    Patient's would be established unless they have not been seen by the physician or anyone in his practice for 3 years because the physician has rendered professional services to them. I just went to a coding conference and they touched on this subject and it was made very clear that it would be established.
    Christina Lee Wagner, CPC, CPC-H

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