Results 1 to 1 of 1

Group or Not?

  1. #1
    Albuquerque, NM
    Exclamation Group or Not?
    Medical Coding Books
    Ok, here's the story...we are a Multi Physician Practice owned by a hospital. We bill under one tax ID, and have been told by our IPA Contracting department that we are "technically" not considered a "GROUP". I know what the definition of a Medical Group is:

    A group medical practice consists of two or more physicians in partnership. Usually, the group shares all responsibilities for patient care.

    Now, are we considered a group? Our physicians are not partners with each other, however, employed.

    My other question is if we are not considered a group, does the guideline for Multispecialty apply, if a patient is seen by a provider, i.e. FP, then seen by our Cardiologist, is the patient new to the Cardiologist or established? According to the 95 & 97 E&M guideline of an established paitent of a "group" the patient would be established. If we are not a "group" the patient would be considered a New Patient?

    Are you now as confused as I am?
    Last edited by penny48; 07-17-2011 at 02:07 PM.

Similar Threads

  1. Group 1 and Group 2 special stains 88312 vs.88313
    By Sharon CPC CEMC in forum Pathology & Clinical Laboratory
    Replies: 8
    Last Post: 03-12-2017, 01:29 AM
  2. Asking more advanced group since
    By Brandy0618 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-11-2014, 01:23 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.