AMA CPT® Assistant - 1998 Issue 1 (January)
Documentation Guidelines, New Patient Definition (Q&A) (January 1998)
January 1998 page 11 Coding Consultation Documentation Guidelines, New Patient Definition (Q&A) CPT describes a new patient as one who has never been seen by a physician or another physician within the same specialty in a group practice. What about a subspecialty? AMA Comment If the subspecialty is part of the same group, then the patient is not considered a new patient, (see New and Established Patient definition, page 1, of CPT E/M Guidelines). Documentation Guidelines, New Patient Definition (Q&A). CPT® Assistant. 1998; January 1998 page 11 ...
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Article Overview
This brief coding consultation article discusses a documentation question related to CPT evaluation and management patient status in a group practice setting. It is relevant to coders, billers, and clinicians who need to understand how specialty and subspecialty structure can affect patient classification under CPT guidance. The article provides a concise AMA response and points readers to the broader CPT E/M guidelines for context.
Why This Topic Matters
Correctly understanding patient status is important for documentation consistency and evaluation and management reporting in group practices.
What You Will Learn
- How this CPT Q&A frames patient status in a group practice context
- The role of specialty and subspecialty structure in documentation review
- Where to look within CPT E/M guidance for related definitions and context
- How AMA commentary addresses a common documentation question
Who Should Read This
- Medical coders
- Medical billers
- Physicians
- Practice managers
- Compliance staff
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