tci Part B Insider - 2004 Issue 31

Evaluation & Management: When Is A New Problem Not A New Problem?

The real question is, when is an E&M service more complex?Think identifying a problem as "new" is a piece of cake? Think again. If a physician sees a patient with a serious illness for the first time, he or she may be tempted to mark the encounter as "new problem." But if other doctors in the practice have already treated the patient for that problem, you shouldn't consider it new for diagnosis and management purposes, according to one carrier. The latest set of frequently asked questions from Part B carrier Palmetto GBA addresses this...

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