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Thread: Same group different speciality new or established?

  1. #1

    Question Same group different speciality new or established?

    AAPC: Back to School
    Does anyone know if you can still bill a new patient office level if the patient was seen by two different doctors in the same group but of a different speciality? The patient sees Dr. A for his intial visit and Dr. A sends him to Dr. B for a consult for surgery. The doctors share the same office and they also share the same patient record. Can Dr. B also bill for a new patient office level?

    For example - a patient A comes in for an initial visit for Dr. D. Patient A fills out Dr. D's paperwork and receives the appropriate services = level 4 visit. At that visit, Dr. D recommends evaluation by Dr. C for a surgical issue. Patient A sees Dr. C for an initial visit (to him) (and is a second visit to the same office) and fills out Dr. C's paperwork was shared, can both doctors still bill a level 4 visit given the appropriate phyiscal exam? Would they have to dictate the up to date history was reviewed???? Additially - how often will they need to update this historical information?

    Any help would be greatly appreciated.

    Thank you.


  2. #2

    Smile Same group different speciality new or established?

    We encounter this frequently as a multi-specialty group practice. The patient would be considered a new patient if seen by two different specialties even if they share the same tax ID. Of course the patient would not be considered new if seen by either doctor within 3 years.

  3. #3


    Thanks Whitaker.

    So when they are using the same medical record in the office, are they able to share the initial paperwork that was signed or do they need to fill out the other Dr's paperwork as well?

    or can any of the medical record that was filled out by Dr. A be used by Dr. B during the patients encounter and just dictate that updated medical record was reviewed in progess note?

    How often do they need to update historical information?

    These questions were asked by one of our offices and I want to make sure I give them the correct answer.

    I think that they can both bill a new patient level if they haven't been seen within the last 3 years. I think they both need to fill out their own initial paperwork and treat the medical record as if it isn't being shared with another dr. I am not sure if they can incorporate the other Dr.'s medical history in with theirs. I think they would have to fill that out theirselves.
    And the historical information should be updated on an as needed basis if anything has changed. Am I thinking correctly?

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