Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

New Patient

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 :
http://www.ama-assn.org/resources/doc/cpt/04-2011-em-and-vaccines-hollmann.pdf
at Page no. 6 to check out the decision tree to distinguish between New and Established patient.

Related Topics