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Thread: New Patient

  1. #1

    Default New Patient

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    We submitted a claim to Medicare for a new patient visit and it was denied. This claim was for Pain Management we also are Anesthesiologist practice under the same tax ID #. The patient was given anesthesia for a surgical procedure earlier in the month. The dx for the office visit was unrelated to the anesthesia.
    When I read the new patient requirements I agree with the denial others in my office say they should of paid it.

    Please advise.
    Judith Anne Cline CPC

  2. #2
    Join Date
    Apr 2007
    Location
    Malone
    Posts
    359

    Default New Patient

    Here is a good article on this
    http://www.aafp.org/fpm/20030900/33unde.html



    Although groups with multiple practice sites may operate independently, with each caring for its own patient population and maintaining its own medical records, they are considered a single group if they have the same tax identification number.



    In a single-specialty practice, the patient's encounter should be reported with a code in a new patient category only if no physician or other provider who reports services using CPT codes in that group has seen the patient within the last three years.

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