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New vs Est Patient

  1. Default New vs Est Patient
    Medical Coding Books
    I know the decision tree rules about new vs. established patient, but what about a doctor who was a member of one group and moved to another group. Are patients who follow him new?

  2. #2
    no, he has an established chart for those patients. I realize it is probably a new tax ID # but he has still established a medical relationship with those patients.

  3. Default RE: Chart
    The chart did not come over with the patient, they belonged to the former practice?

  4. #4
    He still has an established medical relationship with the patient.

    The definition on Page 1 of my CPT Professional states "A new patient is one who has not received ANY professional services from the physician...."

  5. Default
    Thank you very much!

  6. #6
    North Carolina
    In addition to Mbort's comments, below provides some good information on your question. This is an excerpt from the link below~

    "Consider this scenario: Suppose you leave the practice where you have been working for a number of years to join a new group in a nearby community. Some of your patients transfer their care to the new practice and see you within three years of their last visits. You would report these encounters using an established patient code because, although you are practicing in a new group, you have provided professional services to the patient during the last three years. Note that whether the patient has transferred his or her medical records to your office and how long you may have had those records is irrelevant. The amount of time that's passed since your last encounter with the patient is the determining factor."
    Rebecca CPC, CPMA, CEMC

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