Reader Questions: Do This to Distinguish ‘New Patient’ E/M

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

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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