MATHEODO
Contributor
Here is the situation.
Two ortho surgeons in a multi provider practice.
Dr. A specialty is ortho, BUT he is also board certified with a sub-specialty in hand surgery.
Dr. B specialty is also ortho, but he does not have a sub-specialty.
A new patient sees Dr. A for hand issues. The patient also sees Dr. B 2 weeks later for knee issues.
According to CPT guidelines, if I am interpretting this correctly, even though they are both in the same group and both have the same specialty, because Dr. A has a sub-specialty the providers can both bill new patient.
If you look at the decision grid in the CPT manual it appears to support this. Is my thinking correct or am I reading this incorrectly?
Two ortho surgeons in a multi provider practice.
Dr. A specialty is ortho, BUT he is also board certified with a sub-specialty in hand surgery.
Dr. B specialty is also ortho, but he does not have a sub-specialty.
A new patient sees Dr. A for hand issues. The patient also sees Dr. B 2 weeks later for knee issues.
According to CPT guidelines, if I am interpretting this correctly, even though they are both in the same group and both have the same specialty, because Dr. A has a sub-specialty the providers can both bill new patient.
If you look at the decision grid in the CPT manual it appears to support this. Is my thinking correct or am I reading this incorrectly?