Forum - Questions & Answers

Jul 15th, 2009 - TerryC 39 

"new" pt codes

I think that if a "group" of physicians eg: FP,OBG,PEDS,INT-MED all use the same tax ID number, and a pt comes in to see one and the another at another date. The second Dr. cannot charge a new pt visit is that correct?? And what if they use the NPI number along with the Tax ID number??

Jul 15th, 2009 - nmaguire   2,606 

New PT

A new patient code is billed when a physician or same practice, same specialty, has not had a face-to-face within 3 years. It is determined by medical necessity and specialty when they are in same practice. It is not based on Tax ID number, if they are assigned a specialty designation by Medicare and the providers share the same specialty designation--if one or the other sees patient within past 3 years, it is an established patient. Check CMS web site for these 2 digit numbers.

Jul 15th, 2009 - Codapedia Editor 1,399 

New patient

Here's an article about new patients

http://www.codapedia.com/~article_55_.cfm

If the patient had two visits in the day: one with the GYN and one with the FP, and each was correctly enrolled in the Medicare and other private payer systems with their two digit specialty code, each could bill a new patient visit.



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