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new pt or established pt?

  1. Default new pt or established pt?
    Medical Coding Books
    One of the Dr's in my group sees an established pt for a hernia. then the next couple of weeks another Dr in the group sees the same pt for a breast problem. Can the Dr seeing her for the breast problem bill this patient as a new patient since it is the first time he has seen her and it was a different problem?
    Thank You

  2. Default
    no, because they are a group.

  3. #3
    Default
    Quote Originally Posted by ddebbied View Post
    One of the Dr's in my group sees an established pt for a hernia. then the next couple of weeks another Dr in the group sees the same pt for a breast problem. Can the Dr seeing her for the breast problem bill this patient as a new patient since it is the first time he has seen her and it was a different problem?
    Thank You
    It's not the problem, it's the providers' specialties that make the difference. If they are the same specialty (both family practice, for example), then the patient is established. If one's family practice, and the other is internal medicine, or OBGYN/pediatrician/etc., then you can bill a new patient visit for once each, even in the same group. Hope that helps!

  4. #4
    Default
    I agree. And their taxonomy status on NPPES will help with your appeal and prove the separate specialty is a credentialed one!

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