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Fam Pract Manag. 2004 Jun;11(6):18.

The article “Understanding When to Use the New Patient E/M Codes” [September 2003, page 33] contained an error. In its definition of a new patient, Medicare describes professional services as face-to-face encounters, not just evaluation and management (E/M) services as the article suggested. Therefore, if you see a Medicare patient whom you have seen within the last three years, you must report the service using an established patient code even if you didn’t report an E/M code for the service you provided during that time frame. On the other hand, if a lab interpretation is billed, but no face-to-face encounter took place, the new patient designation might be appropriate. Click here to download a corrected version of the decision tree that appeared with the article.


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