Distinguishing ‘new' from ‘established' patients

Why This Topic Matters

Accurate new-versus-established patient classification affects E/M code selection and payment, and the issue can be difficult to verify in larger group practices with multiple locations and specialties.

Article Sections

1. Distinguishing ‘new' from ‘established' patients

   Introduces the patient-status issue in E/M coding and frames the question in the context of multi-specialty practice.

2. CPT and Medicare definitions

   Summarizes the general CPT framework for patient status and notes how Medicare aligns with that approach in its guidance.

3. Operational challenges in larger groups

   Describes why tracking prior encounters can be difficult across offices and care settings, especially in multi-provider environments.

4. Coding tip

   Presents a registration and intake workflow consideration for gathering prior-patient history information.