tci Medicare Compliance & Reimbursement - 2005 Issue 45

PHYSICIANS: CMS Issues E/M Coding Checklist

If three years have passed since his last visit, he's a new patient again.Heads up, physicians: The Centers for Medicare and Medicaid Services tweaked some of the rules for evaluation and management coding in a new transmittal (731), dated Oct. 28. For example, CMS clarified the definition of "new patient" for E/M coding. Experts say the policy hasn't really changed, but CMS is explaining it differently, and it can provide a useful refresher course. According to CMS someone is a new patient if none of a practice's physicians have seen him face-to-face in the past three years...

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