AMA CPT® Assistant - 1998 Issue 12 (December)
Evaluation and Management, New vs. Established Patient (Q&A) (December 1998)
December 1998 page 9 Coding Consultation Evaluation and Management, New vs. Established Patient (Q&A) Question Would it be appropriate to bill a patient as "New" if a physician changes practices and sees a patient that he/she had previously seen within the past three years while working for another medical group? The physician would not have access to the old medical records unless he/she requested them form the previous medical group. AMA Comment The determining factor in assigning and evaluation and management code for New vs. Established patient is whether the patient received professional services from the physician within...
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Article Overview
This short AMA CPT Assistant Q&A addresses a common evaluation and management classification question involving new versus established patient status after a physician changes practices. It is relevant for coders, billers, and compliance staff who need to understand the general scope of the guidance and its place within CPT evaluation and management policy. The article discusses the issue at a high level without presenting a broader training series or multiple case studies.
Why This Topic Matters
Correctly distinguishing new from established patient status affects evaluation and management reporting and helps avoid inconsistent billing when physicians move between groups or settings.
Article Sections
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December 1998 page 9
Publication metadata for the CPT Assistant page where the Q&A appears.
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Coding Consultation
The consultation format introducing the coding question and the AMA response.
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Evaluation and Management, New vs. Established Patient (Q&A)
A question-and-answer discussion focused on evaluation and management patient classification in a general practice-transition scenario.
What You Will Learn
- How this Q&A frames evaluation and management patient classification.
- Why prior physician-patient contact is relevant to the topic.
- How the article situates the issue within CPT Assistant guidance.
- The general context of new versus established patient evaluation and management questions.
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
- Physician office staff
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