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New Patient visit

  1. #1
    Default New Patient visit
    Medical Coding Books
    Our practice shares call with a private practitioner. When seeing his patients we have coded as the guideline states classifying the visit as it would have been by the physician who was not available. In other words, we bill his established patients with those codes. Now there are patient's transferring to our practice from him that I have billed as new patients to our practice. Is this correct? Insurance is denying as new since we have billed in the past as established patients. What do you think? The guideline is not clear on this.
    Thanks!

  2. #2
    Default
    Quote Originally Posted by lmjd View Post
    Our practice shares call with a private practitioner. When seeing his patients we have coded as the guideline states classifying the visit as it would have been by the physician who was not available. In other words, we bill his established patients with those codes. Now there are patient's transferring to our practice from him that I have billed as new patients to our practice. Is this correct? Insurance is denying as new since we have billed in the past as established patients. What do you think? The guideline is not clear on this.
    Thanks!
    Only if your providers have NEVER seen these pt's in another face to face encounter in the past 3 years, if they have seen them while your physicians were on call for the other doctor, then the answer is no.
    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"

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