Medical Billing Forum

Coding => Coding => Topic started by: jennifers1166 on April 06, 2011, 03:52:00 PM

Title: 3 years to the Day...New or Established?
Post by: jennifers1166 on April 06, 2011, 03:52:00 PM
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?? ???
Title: Re: 3 years to the Day...New or Established?
Post by: Anand on April 06, 2011, 04:05:29 PM
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
Title: Re: 3 years to the Day...New or Established?
Post by: PMRNC on April 06, 2011, 04:10:46 PM
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)
Title: Re: 3 years to the Day...New or Established?
Post by: DMK on April 07, 2011, 10:38:25 AM
I vote "new".  A lot can happen in 3 years!!!!
Title: Re: 3 years to the Day...New or Established?
Post by: jennifers1166 on April 07, 2011, 11:27:57 AM
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!!