Wiki New vs Established Problem to Examiner

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kcaskey03

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Hello,
Question on the medical decision making box on audit tool -- on "new problem to examiner" vs "established problem"
(Not new vs established billing like 99213 vs 99203)

For example- if patient sees Dr. A last week for constipation and is told to follow up in 2 weeks. Sees Dr. B then in two weeks for the constipation. (Dr.A and Dr. B are partners in same practice clinic/specialty) Is the constipation for Dr. B on the follow up - 'new' or established.

TIA for any info!
 
Response to question

Regardless if the doctors are different, because they're in the same practice they are considered established.
 
Seems like it qualifies as new per E&M university

Problems are defined relative to the examiner, not the patient. Even if the problem was previously known to other physicians or to the patient, it is still considered new to you if you are seeing the patient for the first time. This situation arises often in the case on consultations.

Good question though, if the physician is really acting as covering for the patients physician, should they be considered the same "examiner"
 
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