AMA CPT® Assistant - 2009 Issue 8 (August)

New vs Established Patient, Decision Tree Explanation (August 2009)

August 2009 page 5 Evaluation and Management:New vs Established Patient, Decision Tree Explanation The Evaluation and Management (E/M) Decision Tree, first printed in the 1999 CPT Assistant and then printed in the 2007 CPT codebook, was revised in 2008 to assist in determining whether to report an E/M service provided as a new or established patient encounter. This article provides clarification regarding how the Decision Tree should be interpreted when E/M codes are reported by the physician, and when appropriate, by the qualified health care professional to describe the services he or she provides to the patient regardless of...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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