tci E/M Coding Alert - 2023 Issue Q4

Back to Basics: Nail Down the Rules for New Vs. Established Patients

Find out what to do if a patient follows a provider. Figuring out whether a patient is new or established can mean navigating a lot of nuance, even though it sounds straightforward. Luckily, despite all of the changes to E/M service coding in the past few years, the CPT® guidelines for new versus established patients have remained the same. Here are four frequently asked questions and answers to help you know how to categorize any patient’s visit as new or established. Understand Why the Categories Exist Question: Why does the distinction matter? Answer: First, “misidentifying a new...

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