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New patient after hospital visit?

  1. #1
    Default New patient after hospital visit?
    Medical Coding Books
    We have a new Doc in a practice who wants to charge new patient visits after seeing the patient in the hospital. According to the documentation, he did a complete visit while in the hospital. When the patient reported to the office for follow up after hospitalization, he wanted to charge a new patient. According to CPT "a new patient is one who has not received ANY professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years." Am I wrong in thinking that he cannot charge a new patient visit, but would charge an established visit? All help appreciated. Thanks

  2. #2
    Duluth, Minnesota
    Hi Anna - I agree with you - the patient is not new to that provider. We have hired providers from other clinics, some of their patients follow them to our facility - different facilities and STILL we cannot charge "new" as these patients have already been seen by that provider within the last 3 years.
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  3. #3
    North Carolina
    Donna is correct. Maybe this link will help your physician.

    "For example, let's say your partner saw a patient who is new to your practice in the emergency department (ED) over the weekend. The following week you see the patient in the office. Since someone else in your practice has seen the patient within the last three years, you have to use an established patient code. This is the case even though the patient had not been seen in the office and there was not an established medical record there"

    This article also addresses a multi-specialty practice
    Rebecca CPC, CPMA, CEMC

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  4. #4
    Thanks for your input. I appreciate it. The article was very informative and helped clarify a lot. Thanks again

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