Wiki New vs Est patient after a flu shot clinic

[ithornton]

If a practice see's patients for a "Flu shot clinic" only receiving a flu vaccination, and was never an established patient in this practice, once they come in to establish care, are they a "new patient" or an "established patient"? Anthem is stating that they are established patients and retracting the New patient E&M, but all the other insurances are accepting them as a "New patient to the practice". Thank you.

 

[renee dustman]

According to the American Academy of Pediatrics:

"Since the 90460-90461 immunization administration (IA) codes require that a physician/qualified health care professional provide the vaccine counseling, reporting a code from the 90460-90461 family always establishes the patient."

https://www.aap.org/en-us/Documents/coding_NewvsEstIACodes.pdf

 

[ithornton]

Thank you Renee, this is perfect, just want I needed. Have a great day.

 

[SharonCollachi]

If a practice see's patients for a "Flu shot clinic" only receiving a flu vaccination, and was never an established patient in this practice, once they come in to establish care, are they a "new patient" or an "established patient"? Anthem is stating that they are established patients and retracting the New patient E&M, but all the other insurances are accepting them as a "New patient to the practice". Thank you.

What I think you mean, is that none of other insurances have recouped payment yet.