ED Coding & Reimbursement Alert - 2022 Issue 1
Reader Questions: Do This to Distinguish ‘New Patient’ E/M
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Article Overview
This reader Q&A explains a common evaluation and management (E/M) scenario involving visits with different physicians in the same practice over time. It focuses on how practice structure, specialty grouping, and taxonomy information affect whether a visit is treated as new or established. The article is relevant to coders, billers, and physician practices that need to understand how CPT patient-status concepts are applied in multi-provider settings.
Why This Topic Matters
Correctly distinguishing new versus established patient visits affects E/M coding and helps practices apply CPT patient-status criteria consistently across providers in the same group.
What You Will Learn
- How the article frames a multi-surgeon patient-status question
- How CPT patient-status concepts relate to group practice and specialty grouping
- How taxonomy information is used in the discussion
- Why the scenario may differ when providers have different taxonomy information
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Surgeons
- Compliance staff
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