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Thread: NP vs Established

  1. #1

    Default NP vs Established

    AAPC: Back to School
    My ENT physician assisted a general surgeon for a thyroidectomy a few months ago. She never saw the patient in clinic, never did an E/M or assessment. Only assist (which of course we did bill out)

    Now the patient is coming to see the ENT for chronic cough and vocal cord paralysis.

    Can we bill this as a New Patient? or since the MD assisted in a surgery and billed out a charge for this patient is she considered established?

    I am thinking she is established, but wanted confirmation before I let the MD know.
    Rachell Lindley, CPC
    Multispecialty Clinic Coding
    Internal Medicine
    General Surgery
    Family Medicine

  2. #2
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    Since it was a "face-to-face" encounter (even though patient was probably already under anesthesia), it will be an established patient, per CPT guidelines.

    Hope this helps,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. #3


    This visit should be billed as Established patient visit.
    Jagadish, CCS-P, CPC

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