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New Patient

G Posted Tue 16th of April, 2019 16:13:13 PM
Last E/M visit for this patient was 9/29/14, but patient has come in to office for allergy 95165 several times last time being 6/13/18. Can a new patient E/M code be billed for date of service 2/19/19 or should it be billed as an established patient? Thank you!
SuperCoder Answered Wed 17th of April, 2019 03:22:47 AM

Hi,

 

Thanks for your question.

 

If a patient has received professional services from the physician/qualified health care professional or another physician/ qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years, then that patient should be considered as "Established".

 

Code 95165 is used for professional services and hence it is an established patient.

 

Please feel free to write if you have any question.

 

Thanks.

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