tci General Surgery Coding Alert - 2023 Issue Q1

You Be the Coder: Clarify ‘Established Patient’

Question: We have a new general surgeon in our group who is now treating one patient from their previous practice. Do we treat this as a new or established patient? California Subscriber Answer: The answer depends on how long it has been since the new surgeon has treated the patient. The chief factor in determining whether a patient is new or established is always time. How it works: If the surgeon new to your practice has provided face-to-face professional services to a patient elsewhere, such as in a hospital or other practice, within the last 36 months, the patient...

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