tci Part B Insider - 2011 Issue 33

Reader Question: Established Patients Remain Established, Despite New Problems

Question: Our office saw a patient six months ago for a certain condition, and sent the patient back to his primary care provider for further treatment. The same patient was recently referred back to us for a different condition. Should we bill that patient as new, since he's coming back for a different reason? Answer: This patient should be considered "established" for many reasons. If your physician sees a patient any time within a 36-month period, that patient is considered established, regardless of the reasons for the visits. This is the AMA's "three-year rule." You should go by...

To read the full article, sign in and subscribe to tci Part B Insider.


Keep pace with evolving Medicare regulations with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI’s Part B Insider will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4800 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.