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Ok, I have a patient that is Medicare, outpatient/observation, is seen by my physician for an initial consult on day one. Patient has been in our office before and within the past three years. Because patient is in hospital for a new reason or illness can I bill a consult code as new patient or do I still need to use established consult code? For instance, with Medicare, if patient is a new consult level three, then we bill 99203, if established we use 99214. I have been lead to believe that if our doctor is seeing a patient in the hospital for a new reason, even though they have been a patient within the past three yrs, we can bill the consult codes used for outpatient new. Can anyone give me some feedback on this? I was under the impression even if it is a new reason such as chest pain, our consult has to reflect established patient? Thank you, Gail, CPC