tci Medicare Compliance & Reimbursement - 2019 Issue 5

Compliance: Fortify 3-Year Rule Smarts with Expert Tips

Sidestep compliance conundrums with this advice. Before you can choose the right E/M code for a service your practice is providing, you must determine whether the patient is new or established. To do this, you’ll likely use the “three-year rule,” but there’s more to the popular guideline than meets the eye. A key element in determining whether a patient is new or established is time. Plus, you need to consider other factors, such as the kind of services a patient has already received, and what kind of exceptions may come into play, before you make...

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