tci E/M Coding Alert - 2021 Issue Q4

Reader Questions: Remember This Rule for ‘Established’ Patient Categorization

Question: A family practice provider in our large practice saw a patient, and the patient was billed for a new patient office/ outpatient evaluation and management (E/M) visit. Several weeks later, the patient was referred to an internal medicine provider within the same practice who has a different taxonomy code from the family physician. Is this patient now considered established, or do we charge a new patient E/M for the internist? AAPC Forum Participant Answer: Per CPT®, a new patient is defined as “one who has not received any professional services from the physician/ qualified healthcare professional or...

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