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Thread: New or Established ???

  1. #1
    Join Date
    Apr 2007
    Terre Haute, IN

    Question New or Established ???

    AAPC: Back to School
    I feel like i'm the Asker of a Million Questions this week !

    Please bear with me since i've never had to do anything remotly as to what
    i've been doing with this new Job !! I hope Someone can help !!

    PT is seen in the ER by the OBG doc. The pt is told she needs to follow up
    the next day. So she does follow up.
    How do we bill the E&M for the Office Visit the.

    We are Divided about which way to go here.
    Is this An Established Patient because he saw her in the ER?
    or is this a New Patient because he has not seen her in his Office?

    Thanks again !

  2. #2
    Join Date
    Apr 2007
    North Carolina


    She will be established to your practice...

    By CPT definition, a new patient is “one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years.”

    Since the face-to-face visit took place in the ER and her subsequent visit was at the providers office, she is considered established (same specialty-seen within past 3 years)

  3. #3
    Join Date
    Apr 2007
    Terre Haute, IN


    Thank you Very Much !!

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