Wiki Established vs New PT Conflicting Info

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jojoboyer10

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Receiving conflicting info for the following, can anyone help?

Anesthesiologist administered anesthesia to a surgical patient several years ago under a different practice. Recently, the anesthesiologist began treating the same patient for pain under a different practice. How would the E/M be billed?
 
1. If the bill for the previous procedure went out with a different tax ID than he/she has now, then the patient is new.

2. If the previous encounter was 3 years ago or longer then it is a new patient regardless of the tax ID.

See the New Vs. Established patient flow chart in the CPT book for more info.
 
Established patient if within 3 years

Regardless of whether the anesthesiologist was with a different practice, if face-to-face service was provided within the last 3 years by the same physician or by the same practice the patient is considered established.

So if the anesthesiologist provided service to the patient within the last 3 years, the patient is established.

If the patient was seen by another physician in this practice of the same specialty within the last 3 years, the patient is established.

F Tessa Bartels, CPC, CEMC
 
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