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Thread: E/m coding

  1. #1

    Question E/m coding

    AAPC: Back to School
    I have a coding question regarding E/M new patient versus established patient.

    The patient is seen in the hospital for the first time for a perm cath insert on 09/07/2010, no E/M was done. The patient is now coming in on 09/10/2010 is the patient New patient to us for establsihed?

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


    According to the CPT guidelines for distinguishing between new and established patients, since the previous service was face - to - face (insertion of cath), the patient would be established. Even though no E/M was separately performed at the encounter, this would still be an established patient.

    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

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