Wiki 2023 EM new rule for New patients-Clarification needed

MSCALLIE79

Networker
Messages
32
Location
Clover, SC
Best answers
0
Hello all,

I am a multi- specialty ophthalmology practice, and have a questions regarding an article we received from North American Neuro-Ophthalmology Society, I am trying to prevent denials, but my physician now have a questions since we have 6 subspecialties but we all bill under 1 Group NPI.
Can we bill a new patient exam under the sub-specialty taxonomy and each sub-specialty receive a new patient exam within the same group NPI?

Dear Members of the North American Neuro-Ophthalmology Society,

We would like to inform you of the new changes to billing E&M visits effective January 1, 2023. The new wording states that established patient visits (E&M 99212-99215) refer to patients seen within a practice by a physician “in the exact same specialty and subspecialty”. This means that a patient seen by a non-neuro-ophthalmologist within the same practice (cornea, glaucoma, retina, etc.) but not by the neuro-ophthalmologist should be billed as a new visit (E&M 99202-99205).
 

Attachments

  • 2023 EM article from North American Neuro-Ophthalmology.pdf
    500.3 KB · Views: 16
Those are my understandings of the new vs. established patient assignment criteria. Hopefully, the taxonomy code will differentiate when you file claims so they don't reject based upon them having been seen by another provider in the office.

Tom Cheezum, OD, COPC
 
Top