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new pt vs established pt

  1. #1
    Default new pt vs established pt
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    A new physician to a group has a patient from his previous practice that has followed him to his new practice. He has not seen this pt for about a year. Would this be considered a new patient since it is with a new practice or an established patient since the physician has seen this patient before.

  2. #2
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    ENGLEWOOD/DENVER
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    Established.

  3. #3
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    Duluth, Minnesota
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    yup... I agree with mbort - established
    Donna, CPC, CPC-H

  4. #4
    Default New vs Established patient
    It would have to be an established patient because the patient was seen by the physician within the past three years. I doesn't matter that it was at a different practice previously, the definition is " one who has received professional services from the physician, or another physician of the same specialty who belongs to the same practice." The "same practice" only matters for another physician in the group/specialty.

  5. #5
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    North Carolina
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    Here's a nice link that goes into detail...

    When you change practices

    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.

    http://www.aafp.org/fpm/20030900/33unde.html#Box_D

  6. Talking New Physician New Practice - Established Physicians?
    Quote Originally Posted by RebeccaWoodward* View Post
    Here's a nice link that goes into detail...

    When you change practices

    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.

    http://www.aafp.org/fpm/20030900/33unde.html#Box_D
    Ok, so you have a new physician starting with a new practice with patients that are following him/her to that new practice. What are they considered once they see one of the original established physicians? Would they still be considered "established" or "new" since they have never seen these physicians before at that particular practice?

    Thanks so much!

  7. #7
    Default
    Wow, this is getting more complicated than the plot of inception. So the new provider joins a practice, and has patients who follow him to the new practice. You're asking if those patients would be 'new' or 'established' if they saw one of that practice's providers after they saw the original 'established provider in the new practice? Assuming all of the providers at the new practice are the same specialty, they would be established patients. However, if the patient saw their original 'established' provider (internal medicine let's say) and then saw another provider in the new practice (cardiologist let's say) then they could be considered a new patient, since the specialty is different.

    ....unless of course Leonardo DiCaprio planted that thought into my head while I slept.
    Mike Enos, CPC, CPMA, CEMC
    Consultant, Chart Auditor, Instructor
    Enos Medical Coding
    Warwick, Rhode Island

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