Wiki 2 new E/M visits

[TMHales]

If we see a new patient for a workers compensation injury and on the same day see the patient for a completely different problem that has nothing to do with work comp and do a separate note, can we bill 2 new patient codes? One to work comp and the other to his private insurance?

 

[mlbaker1974]

No you can't. The first visit would get the new patient code and the second would be an established patient visit, but it would be for a "new" problem. Per CPT to assign a new patient E/M the patient can not have been seen by any provider in the same practice within the past 3 years, after that initial visit the patient is considered established regardless of which carrier is billed. But a word of warning, if an auditor sees a new and established visit on the same day especially if this happens with multiple patients, they are going to wonder what is going on.