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Family Practice vs. Internal Medicine New or Est.

  1. #1
    Default Family Practice vs. Internal Medicine New or Est.
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    We have a multiple specialty practice (OB/Gyn, FP, IM, Peds, GI), 3 clinics but only one tax id number. We have FP providers that have a "home" clinic who do not see patient's at any of our other clinics, but we do have some "specialty" providers that "float" between clinics. These specialties are OB/Gyn, GI and IM. With that here is my scenario and question:

    Patient walks in to the clinic, needs to see a provider for an acute condition, now all the FPs that the patient has established care with are booked. BUT the IM provider that is there that day is availlable, but the patient has not received any professional services from our IM practice. The patient see the IM provider. IS THIS A NEW PATIENT VISIT OR AN ESTABLISHED PATIENT.

    I say it's a new patient visit according to AMA CPT E/M Service Guidelines.

    Stefanie Cramer, CPC
    Independent Contractor
    Medical Coding and Consulting
    Cramer Consulting

  2. Default
    Technically, since they're of different specialties the patient would be new. However, if the only reason the patient is seeing the internist is because they can't get in to see their family practitioner, it might be considered "good practice" to just charge the service as if the patient is established.

    Just my two cents


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