Cheezum51
True Blue
A little different scenario in the new versus established patient definition:
A doctor purchases the practice of another doctor of the same specialty. The practice, under the new owner, is now under a new group NPI number for his professional corporation. The new practice owner never saw any patients in the practice prior to purchasing it. The previous practice owner now works for the new corporation as an employee one day per week.
When the new practice owner sees a patient who had been examined by the previous owner, prior to the practice purchase, less than 3 years ago, is that visit with the new doctor coded using a new patient CPT code?
My opinion is that it is a new patient to the new practice owner since the practice is now registered with a new group NPI number and the NPI for the individual provider had not been affiliated with that practice before. If the patient were to be seen again by the prior owner, I think that would necessitate using the established patient codes.
Any input or clarification would be appreciated.
Tom Cheezum, O.D., CPC
A doctor purchases the practice of another doctor of the same specialty. The practice, under the new owner, is now under a new group NPI number for his professional corporation. The new practice owner never saw any patients in the practice prior to purchasing it. The previous practice owner now works for the new corporation as an employee one day per week.
When the new practice owner sees a patient who had been examined by the previous owner, prior to the practice purchase, less than 3 years ago, is that visit with the new doctor coded using a new patient CPT code?
My opinion is that it is a new patient to the new practice owner since the practice is now registered with a new group NPI number and the NPI for the individual provider had not been affiliated with that practice before. If the patient were to be seen again by the prior owner, I think that would necessitate using the established patient codes.
Any input or clarification would be appreciated.
Tom Cheezum, O.D., CPC