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How to code patients when you absorb an existing practice

  1. Default How to code patients when you absorb an existing practice
    Medical Coding Books
    What would be the proper coding when an existing practice purchases a practice from an estate of a deceased physician? They would purchases all assets, including patient accounts. Would these patients upon their first visit with the new owners (providers) be billable as new patient or established patients, since any new charges would be be billed under a different tax id number?
    They would be filed under the new owners tax id.

    Thanks for any suggestions,

    Brenda Mc

  2. #2
    I would imagine that the insurance companies would consider them new patients. In my practice, all doctors bill under the same tax id#, if one doctor sees the patient and then the patient sees a different doctor (one they've never seen before) within the practice, they're still considered an established patient...they're all billed under that one tax id#. So, I would imagine if charges for these patients are billed under a different tax id#, they should be considered new. And they are actually new patients, they have never been seen by this doctor before, he was not a part of the old practice right? That's just what I think anyway. Sorry I don't know where to find this in writing...

  3. #3
    Default E&M services codes
    I agree with you if physician changes and his tax ID number changes you would consider the patient as new patient. Please refer to the CPT book 2007 or recent edition, a table in E&M chapter and this table will give nice explanation.

  4. #4
    Milwaukee WI
    Default Established vs new
    Balloju writes: if physician changes and his tax ID number changes you would consider the patient as new patient
    This is INCORRECT. If a physician joins your practice and his patients follow him they are established patients, even though he is now billing with a new tax ID #.

    However, I think in your scenario, where your practice has purchased the patient list from a deceased physician, they would be considered new, as long as no one in your current practice has provided services to the patient within the last three years.

    F Tessa Bartels, CPC, CPC-E/M

  5. #5
    I agree with F Tessa

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