Shawn Posted Tue 19th of February, 2013 01:09:49 AM
What's the correct coding of a patient that returns to an orthopedic practice after 5 years. Physician billed '99214' but the coder feels it should be '99203'.
SuperCoder Answered Tue 19th of February, 2013 05:08:02 AM
The correct code will be 99203 as after five years the patient will be considered a new patient. As per AMA guidelines, if a patient visits the same specialty after 3 years, he will be considered a new patient. You can also visit AMA site at :
at Page no. 6 to check out the decision tree to distinguish between New and Established patient.