Orthopedic Coding Alert

Reader Questions:

New Patient Qualifications

Question: When can we bill for a new patient in the group? This patient had been seen previously by our physician, but not for many years?

Anonymous TX Subscriber

Answer: CPT defines a new patient as one 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. This is the accepted definition by virtually all carriers.
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

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.