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Neurosurgery Coding Alert

Reader Questions:

New Surgeon May Bring Established Patients

Published on Fri Nov 16, 2007

Question: We have a new surgeon who is coming over from a nearby county, so of course she has her own patients who will be following her. Should we charge her patients as new, or will they be established because she has seen them? She was practicing and billing under another tax identification number and will be changing to ours when she starts. North Carolina Subscriber Answer: If your new surgeon or any other physician of the same specialty has seen the patient within a three-year timeframe, you should count the patient as an established patient (99211-99215), according to AMA guidelines as outlined in CPT. If your new surgeon or any other physician of the same specialty in your practice has not provided any professional services to the patient in the past three years, you should consider the patient new (99201-99205). -- Technical and coding guidance for You Be the Coder and Reader Questions provided by Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison.
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