tci Medicare Compliance & Reimbursement - 2012 Issue 7

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...

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