# NP Visit and previous echocardiogram



## GBielskis (Aug 15, 2013)

Does anyone know if a patient has a echocardiogram in the doctor's office previous to being seen as a new patient - can a new patient code be used?  I was told at a seminar that it could be billed as new patient when a previous echocardiogram was done because the echocardiogram is not considered "face to face" by coding guidelines.  I cannot find any specific reference to this.  There is no physician supervision required for an echocardiogram.  I know if a patient had a previous stress test, then the patient is considered an established patient for followup.  Supervision requiried for stress.


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## Misty Dawn (Aug 17, 2013)

GBielskis said:


> Does anyone know if a patient has a echocardiogram in the doctor's office previous to being seen as a new patient - can a new patient code be used?  I was told at a seminar that it could be billed as new patient when a previous echocardiogram was done because the echocardiogram is not considered "face to face" by coding guidelines.  I cannot find any specific reference to this.  There is no physician supervision required for an echocardiogram.  I know if a patient had a previous stress test, then the patient is considered an established patient for followup.  Supervision requiried for stress.



Per Medicare Claims Processing Manual chapter 12, Section 30.6.7 defines a new patient fist as: 

A Definition of New Patient for Selection of E/M Visit Code 
Interpret the phrase “new patient” to mean a patient who has not received any professional services, i.e., E/M service or other face-to-face service (e.g., surgical procedure) from the physician or physician group practice (same physician specialty) within the previous 3 years. For example, if a professional component of a previous procedure is billed in a 3 year time period, e.g., a lab interpretation is billed and no E/M service or other face-to-face service with the patient is performed, then this patient remains a new patient for the initial visit. *An interpretation of a diagnostic test*, reading an x-ray or EKG etc., in the absence of an E/M service or other face-to-face service with the patient does not affect the designation of a new patient.

According to the Centers for Medicare and Medicaid Services (CMS), a new patient is a patient 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.  

CMS clarified their definition of a New Patient Visit. As you can see in the above exert; the definition specifically states that diagnostic test in the absence of an E/M service or other face-to-face service with the patient does not affect the designation of a new patient. 

HTH, Misty Sebert CPC, CCC


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## RILEY1959 (Aug 25, 2013)

An Echo is not considered face to face so the patient may be a "new" patient


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