Anesthesia Coding Alert

READER QUESTIONS:

Established Pt Stays Established With New Doc

Question: We hired a new physician for our practice after another doctor left. The patients are not new to the practice. How should I code patient follow-ups to new physicians within the same practice? Colorado Subscriber Answer: CPT rules clarify that patients are considered to be established if they have had a face-to-face professional service with the provider or a provider of the same specialty in the same group practice within the past three years. The follow-up visits with your new physician would be reported with an established-visit code, 9921x (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components ...) Take note: A patient could be considered new if neverseen by a provider of the same specialty within the past three years even though they have seen different specialty physicians in a multi-specialty group within [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Anesthesia Coding Alert

View All