Wiki New patient vs. established patient

[andrea1415]

Hi All,
Two MD's at the practice are retiring and many of the patients are opting to establish with the other doctors within the practice. These physicians do not bill under a group TIN as they are all private practice. Since these patients have been seen by a physician in the office within the past three years it is my understanding that a new patient E&M code cannot be used for the first visit with the new MD. Please correct me if I'm wrong. Thank you!

 

[aclements]

Straight from the CPT code book. "A new patient is one who has not received any professional services from the physician/qualified health care professional or another physician/qualified health professional of the exact same specialty and subspecialty who belongs to the same group practice within the past three years." There is also a decision tree in the code book to help you out.

I hope this helps you!