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Thread: new patient vist within group practice

  1. #1
    Join Date
    Apr 2007

    Question new patient vist within group practice

    AAPC: Back to School
    Since we can no longer charge a consultation to medicare. Can we charge a new patient visit instead?
    Patient was referred by dermatologist to another in the group with 'specialty in MOHS'. The patient was treated by the MOHS provider for an unrelated diagnosis within the past 3 years. A consultation was appropriate in this situation prior to Medicare new ruling on consults. Can the MOHS provider charge the new pt visit?
    Do taxonomy codes play a part to differintiate the MOHS as being specialized for the claim submission?
    Last edited by jmoretto; 05-11-2011 at 07:57 AM. Reason: wrong subject code / new patient visit vs post op

  2. #2
    Join Date
    Apr 2007
    Phoenix, AZ


    If the dermatologist is referring to another dermatologist in the same group, you cannot bill a NP. Per CPT guidelines, 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 last three years.

    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

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