Reader Question: Use These Details to Decide Patient Status

Article Overview

This article addresses a pediatric inpatient-to-office follow-up scenario and discusses how prior physician contact changes patient status for subsequent evaluation and management coding. It is aimed at coders and billers who need help determining whether an office visit should be reported as a new patient or established patient service under CPT office/outpatient E/M rules. The article focuses on patient-status determination, documentation context, and selection among office visit code families without giving broader policy guidance beyond the scenario presented.