Otolaryngology Coding Alert

Question: When a physician joins a new practice and sees patients from the former practice within three years of the previous visit, should you code the evaluation and management (E/M) encounter as new or established?

New York Subscriber

Answer: Whether the physician joins a new group practice or begins their own practice, the answer remains the same. The physician should code according to the time frame with which they last saw the patient. So, if you saw a patient two years prior, and the next visit takes place at a new practice, you should still bill the patient as if they are an established patient.