tci E/M Coding Alert - 2023 Issue Q1

Reader Question: Rely on Knowledge of This Technicality for New Versus Established Patient

Question: Our clinic had a patient come in for a wellness visit. They had only been to our clinic once before and only to get a vaccine, and they didn’t see the doctor then. Would this patient be new or established for the wellness visit encounter? AAPC Forum Participant Answer: This one likely will come down to a technicality, but it’s probably best to consider the patient to be established at the wellness visit. Here’s why. First, let’s take a look at the CPT® guidelines, which state, “An established patient is one who has...

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