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New Vs Patient

Shane Posted Mon 23rd of June, 2014 14:26:59 PM

I have an ophthalmologist and optometrist whom work at the same practice. Can they each bill for a new patient encounter because they are different specialties?

SuperCoder Answered Mon 23rd of June, 2014 15:01:02 PM

Thank you for your question.

Yes, they can both bill for the new patient visit.

CPT says a new patient hasn't received any services -from the physician or another physician of the same specialty who belongs to the same group practice, within the past three years.- The Medicare Claims Processing Manual says physicians -in the same group practice but who are in different specialties may bill and be paid without regard to their membership in the same group- (Chapter 12, section 30.6.5). So if you work in a multi-specialty practice and your patient sees a physician from a new specialty, you can bill it as a new patient visit.

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