AMA CPT® Assistant - 2008 Issue 11 (November)
Evaluation and Management/Office or Other Outpatient Services (November 2008)
November 2008 page 10d Evaluation and Management/Office or Other Outpatient Services Question: Can new physicians who come on board to a group practice with their own tax identification numbers charge a new evaluation and management code for patients they see? Answer: According to CPT guidelines, a new patient is one who has received no professional services from the physician or another physician of the same specialty who belongs to the same group practice within the past three years. Also, if a physician is new to this group practice and had never seen or billed a patient previously though his...
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Article Overview
This article explains a CPT-based office and outpatient evaluation and management scenario involving physicians who are new to a group practice and how patient status is viewed in that context. It is intended for coders, billers, and physician office staff who need to understand the general circumstances discussed in the CPT Assistant guidance and determine whether the full article applies to their situation.
Why This Topic Matters
Correct patient-status interpretation affects evaluation and management reporting in physician practices, especially when providers join a group and begin seeing established patients under different tax identification numbers.
Article Sections
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November 2008 page 10d
A brief CPT Assistant discussion centered on office and outpatient evaluation and management billing in a group practice setting.
What You Will Learn
- How the article frames a group-practice office/outpatient evaluation and management question
- What general CPT guidance is discussed for new physicians joining a practice
- How the article situates the topic within physician billing and patient status concepts
- The scope of the CPT Assistant commentary for the November 2008 issue
Who Should Read This
- Medical coders
- Billing staff
- Physician practice administrators
- Compliance staff
- Office managers
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