Wiki new pt vs est pt

[bakr00]

help help! I have a scenario I need advice on. We have an office that we recently bought and staffed with physicians from our other offices. We have a new name and new Tax ID #, and a lot of patients that have stayed from the previous doctor. When these patients are seen, are they new pts?

 

[Wendyh50]

Irregardless of tax payer ID's it is about the group

CMS defines a "new" patient in Chapter 12 Section 30.6.7 (PDF download) of the Medicare Claims Processing Manual as "a patient who has not received any professional services, i.e., E/M service or other face-to-face service (e.g., surgical procedure) from the physician or physician group practice (same physician specialty) within the previous 3 years." This is essentially the same definition as in Current Procedural Terminology (CPT), which states, "A new patient is one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years." CPT defines "professional services" as "those face-to-face services rendered by a physician and reported by a specific CPT code(s)."

A simple way to determine if a patient is new is to ask yourself this question: "Have I (or another physician of my specialty within our group practice) provided a face-to-face service to this patient within the past 3 years?" If the answer is no, then the patient is new to you for purposes of coding and billing the E/M service that you are providing to him or her.

 

[sumeet_lawhare@yahoo.com]

..

my view on this go this way.. Some big hospitals have many branches so their medical records are shared with every branch and the patient can go to any branch and if he is seen by same physician specialty he is considered establish.. cause the physician already have his medical info of the patient.....
i guess the idea for new and establish patient is because when the patient is new we have to get his previous medical coditions and document the same.

Hope this helps

Sumeet