Radiology Coding Alert

Question: We’ve got a new interventional radiologist who is seeing patients from their former practice within three years of the previous visit. Should I 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 fewer than three years ago, and the next visit takes place at a new practice, you should still bill the patient as if they are an established patient.