Reader Question: Determine New vs. Established by Service, Not E/M

Article Overview

This article addresses a practical coding question about patient status classification for office and related services. It explains the general CPT and CMS framework for distinguishing new from established patients, why the distinction matters for billing and documentation, and how the discussion applies when a patient has received other professional services in the practice during the lookback period. It is intended for coders, billers, and compliance staff who need to understand how service history can affect patient classification.