decisionhealth Newsletters, Coder Pink Sheets - 2002 Issue 5 (May)
New twists on “new” vs. “established” E/M visits
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Article Overview
This article addresses how new versus established patient status is viewed in E/M coding when physicians move between practices, work under locum tenens arrangements, or see patients in a newly organized group setting. It is aimed at coders and practice staff who need a clearer understanding of how patient history, physician relationship, specialty grouping, and recent face-to-face care factor into visit classification. The discussion focuses on general coding guidance for real-world practice transitions and record-keeping changes.
Why This Topic Matters
Patient classification affects E/M visit coding and can change how an encounter is reported during practice mergers, staffing changes, and physician transitions. Understanding the general framework helps avoid misclassification when care is delivered by different physicians or within different practice entities.
Article Sections
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New twists on “new” vs. “established” E/M visits
Introduces two practice-transition scenarios involving patient status for evaluation and management visits. The section frames the coding question in the context of locum tenens coverage and physician movement between practices.
What You Will Learn
- How the article approaches new versus established patient status in E/M coding
- Why practice structure and physician transitions can create coding uncertainty
- How the article frames common real-world scenarios involving office visits and patient records
- What general factors are discussed when determining patient classification across physicians and groups
Who Should Read This
- Medical coders
- Coding auditors
- Physician office staff
- Practice managers
- Revenue cycle personnel
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