Medical Billing Forum
Coding => Coding => : jennifers1166 April 06, 2011, 06:52:00 PM
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If we had a patient come to the office 3 years to the day of their last visit with the same Dr. is this an established patient or new?? ???
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If we had a patient come to the office 3 years to the day of their last visit with the same Dr. is this an established patient or new?? ???
By CPT definition, a new patient is “one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years.” By contrast, an established patient has received professional services from the physician or another physician in the same group and the same specialty within the prior three years
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So that day is "within" the 3 years.. oiy vey! Guess you could check back 3 years to see if the appt time was beyond the 24 hours?? LMAO (sorry I couldn't resist)
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I vote "new". A lot can happen in 3 years!!!!
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Thanks for your help....we did find out from CMS they consider it a new patient...for example patient comes in on april 1st 2008 so on april 1st 2011 they are a new patient...if they come in before midnight on march 31st they are considered established yet....that's the word we got....thanks again!!