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Anesthesia Coding Alert

Reader Question:

Remember Face-to-Face in New vs. Established

Question: We saw a patient for pain injections earlier in the year and he is now coming in for an office visit for evaluation. Do I bill a new patient code since patient was never seen for an office visit before or do I use an established patient code since we have done injections on the patient? West Virginia Subscriber Answer: Use an established patient code. CPT's rule on established versus new patient depends only on whether the physician (or a same specialty partner in the same group) has provided face-toface services or procedures to the patient in the past three years. How it works: CPT clearly defines what qualifies as an established patient: "An established patient is one who 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." Ask yourself, "Has the [...]

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