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Thread: Coding for New Dr/Old Pts

  1. #1
    Join Date
    Apr 2007

    Default Coding for New Dr/Old Pts

    AAPC: Back to School
    Our office is employing a semi-retired physician, who will be seeing his old patients in our office. We will bill under his name with our practice tax ID and pay-to. Would we code these patients as new or established visits? They do have to fill out new paperwork and we have to input their history, etc. from their old paper chart to our EMR. We have asked a couple of different offices, who say it could go either way. Some here think we should bill them all as new patients. I want to do what is right from a coding/auditing standpoint. I would like to bill them as established, as they are well known to the doctor. Suggestions??

  2. #2
    Join Date
    Apr 2007
    North Carolina


    If these patients have received professional, face-to-face services from this physician within the last 3 years, they will be considered an established patient.


    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.


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