# New problem or established?



## 1073358 (Mar 2, 2009)

Here's the scenario: Family dr sees their established patient several times for knee pain. Family dr sends patient to ortho. Ortho decides patient needs surgery. Ortho sends patient back to family dr to do the pre op HP consult. When I am auditing the pre op consult, is the dx a new problem or established? The reason for the preop is clearance for surgery, so I am not sure if I should count that as a new problem no added workup or if I should count the actualy reason for the surgery as the dx? Make sense?


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## rthames052006 (Mar 2, 2009)

1073358 said:


> Here's the scenario: Family dr sees their established patient several times for knee pain. Family dr sends patient to ortho. Ortho decides patient needs surgery. Ortho sends patient back to family dr to do the pre op HP consult. When I am auditing the pre op consult, is the dx a new problem or established? The reason for the preop is clearance for surgery, so I am not sure if I should count that as a new problem no added workup or if I should count the actualy reason for the surgery as the dx? Make sense?



It would not be a new problem to the family dr, this pt has been seen as you stated several times for knee pain, it would have been a new problem to the ortho.  Surgery is for the same "knee pain" that the family dr had been seeing this pt for, the ortho ( being the specialist) decided it needs to be operated on.


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## RebeccaWoodward* (Mar 2, 2009)

I agree with Roxanne...est problem to the family MD


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## 1073358 (Mar 3, 2009)

Where I am hung up is after ortho says ok, you need surgery. Go back to family dr for HP consult.

The family dr is seeing patient for surgery clearance. He really is not seeing him for knee now, so is it still established problem?


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## pamtienter (Mar 3, 2009)

Even though the visit is for a pre-operative clearance, which may be something the FP hasn't seen the patient for before, the underlying reason for the visit is knee pain, which is the established problem. Still est problem.

I get the confusion. Seems the more we think things through, the more 'round and 'round we go!


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