If a particular doctor provides a new patient with a standard office-visit E/M, can you use an established patient E/M to code the encounter?
Well, this is not the right way to go about. If you do so, your practice could be in for disappointment. What's more, Medicare's doing away of consultation codes means that coders will have to answer the new versus established question more than before.
For Medicare payers, and payers that follow their lead, E/M coders will have to select the right code, new or established to bill for what used to be consults and didn't have a new versus established, to bill for what used to be consults and didn't have a new vs. established component concept.
Do not get the doctor steamed; nail the patient's status every time by following this piece of advice on new and established patients.
For family practices coding, the main difference between new and established patient codes is the payment rate.
Ask three-year question first
If your patient has had a face-to-face service with the FP within the last three years, then the patient is established.
Face time a must for established patients
What does a coder do when the patient has got treatment from the doctor within the last three years, however the physician didn't actually see the patient? This is a different coding situation.
As an emergency medicine coder, you will encounter situations relating to such as this at regular intervals. So if you are to avoid tricky situations regarding new and established patient encounters and ensure the cash keep flowing, head straight to Orlando, FL this December for an emergency medicine coding conference.