Wiki new vs est pt. for a NP

[melissamiller]

I know this topic has been discussed, but we have a nurse practitioner that moved from one group practice to another group practice not affiliated with each other. In the move, she brought her patients with her, do we code them as new patients to the practice or est. patients b/c she has seen them in the last 3 years, but we have no documentation i.e. their charts, telling us that. Thank you.

 

[ElaineM]

There is a nice diagram in the CPT book (decision tree - page 5) to help with your question. It has helped me when these come up.

 

[RebeccaWoodward*]

I know this topic has been discussed, but we have a nurse practitioner that moved from one group practice to another group practice not affiliated with each other. In the move, she brought her patients with her, do we code them as new patients to the practice or est. patients b/c she has seen them in the last 3 years, but we have no documentation i.e. their charts, telling us that. Thank you.

Established...

When you change practices

Consider this scenario: Suppose you leave the practice where you have been working for a number of years to join a new group in a nearby community. Some of your patients transfer their care to the new practice and see you within three years of their last visits. You would report these encounters using an established patient code because, although you are practicing in a new group, you have provided professional services to the patient during the last three years. Note that whether the patient has transferred his or her medical records to your office and how long you may have had those records is irrelevant. The amount of time that’s passed since your last encounter with the patient is the determining factor.

http://www.aafp.org/fpm/2003/0900/p33.html