Is that patient new?
Fam Pract Manag. 2004 Feb;11(2):17.
To the Editor:
I recently read Emily Hill’s “Understanding When to Use the New Patient E/M Codes” [September 2003, page 33]. I work for a physician with an established private practice, but he occasionally works in an urgent care clinic and bills under the clinic’s tax identification number for patients he sees there. If he sees a patient at the clinic who then comes to the private practice, should our practice submit a new patient code or an established visit code?
The CPT definition of 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.” The key word in the CPT definition is “or.” If an individual physician provides professional services to a patient, in any location, within a three-year period, the evaluation and management (E/M) services are reported using established patient visit codes (99211-99215). The issues of specialty and group tax identification numbers apply only when the patient sees another physician in the same group.
Copyright © 2004 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions
More in FPM
Related Topic Searches
MOST RECENT ISSUE
Access the latest issue
of FPM journal
Is the PCF model right for your practice? Evaluate potential opportunities and risks for your practice. Use the PCF Practice Assessment Checklist to gauge your practice’s readiness to participate in PCF, including care delivery capabilities, data infrastructure, and potential financial impact.