Gastroenterology Coding Alert
Reader Question:
Count “No Charge” Visits Toward 3-Year New Patient Status
Published on Wed Jan 22, 2020
Question: Our gastroenterologist saw a patient during a quick assessment last year at no charge. The patient returned this week for a complete exam. Should this be billed as an established patient or new? New Hampshire Subscriber Answer: In this situation, the patient will be considered “established” because you already treated him during a face-to-face encounter within the last three years, which constitutes an established patient under the CPT® guidelines. The fact that you didn’t charge the patient for the initial visit is irrelevant to the patient’s status as new or established — what matters is that you previously saw the patient face-to-face within the last three years.
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Gastroenterology Coding Alert
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Count “No Charge” Visits Toward 3-Year New Patient Status
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