Reader Question: Here's When To Treat Established Patients As New
Question: We saw a patient over a year ago for a thyroidectomy, and now the patient returned to our practice with sinus complaints. The physician performs a nasal endoscopy. Should we bill the nasal endoscopy encounter as a new patient since she's coming back for a different reason and seeing a different otolaryngologist?
Answer: No, you should not bill this case as a new patient. You should bill this as an established patient for several reasons.
If your otolaryngologist sees a patient any time within a 36-month period, that patient is considered established, regardless of the reasons for the...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: