If another physician is requesting your specialist's advice/opinion on the management of the patient's problem, then it is a consult. Even if the patient has been previously seen in your clinic for the same or similar problem.
If the patient is being referred for care of a problem, then it is a new or established patient depending on whether this patient has seen anyone of the same specialty and same practice in your clinic in the last 3 years. So if John Doe has a painful knee and saw Ortho Doc A in May for this problem, and now is coming in with the same painful knee and will see New Ortho Doc B ... John Doe is an EXISTING patient. (Even if New Ortho Doc has never seen the patient himself.)
Hope that helps.
F Tessa Bartels, CPC, CEMC
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