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New Patient

  1. #1
    Default New Patient
    Medical Coding Books
    We have added a new Doctor to our Group. Can we bill the first visit for the patient as a new patient visit or would it be established. The patient was his patient when he was privately owned.

  2. #2
    Default
    Quote Originally Posted by loribwelch View Post
    We have added a new Doctor to our Group. Can we bill the first visit for the patient as a new patient visit or would it be established. The patient was his patient when he was privately owned.
    If Dr has seen patient within last 3 years, then this patient is not new to practice.

  3. Default
    This is a bit confusing. We run across the same thing because we employ all our physicians and bill under the same tax id number for all. But we have some that have private practices and bill under different tax id numbers.

    Ethically, I think if the individual physician has seen the patient within the last 3 years a new patient charge should not be billed. There are probably people who will disagree with me though.

  4. #4
    Default New Patient
    If you bill under the same tax id it would not be a new patient. The exception to this is if it a provider of a different specialty. For instance you have a family medicine physician who has seen a patient and that patient needs to be seen by a rheumatologist. The rheumatologist could bill a new patient visit. If the newly hired physician has brought patients with him from his previous practice then those patients would be billed as established patient visits.

  5. #5
    Location
    Dover Seacoast New Hampshire
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    2,016
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    E&M services are face-to-face professional services. If the doctor has seen the patient (face-to-face) within the past three years, even at another practice site...then bill an established patient visit.

    The guidelines are in CPT, they are also published in CMS.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

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