James Posted Wed 19th of December, 2012 15:28:07 PM
My doctor saw a patient in the hospital. After the patient was discharged from the hospital he was instructed to follow up with the doctor at our office. The doctor coded a 99213, but I told him he was wrong that it should have been code 99203 for new patient visit, the patient was never seen in the office before. He said no, that he was not a new patient because he saw him in the hospital. Please help. Who is correct?
SuperCoder Answered Thu 20th of December, 2012 20:51:01 PM
If the provider has seen the patient face-to-face within the last three years, it doesn't matter which practice the provider was with, the patient is still established to that provider. New vs. established is whether that particular provider has seen the patient within the past three years.