New Patient or Established

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November 1, 2018

Question:
If I see a new patient in consultation for a joint pain, treat and release them to their primary care provider and they come back to see me a year later for a different reason on their own, can I code them as a new patient? 

Answer:
No.  According to the CPT guidelines, a new patient is a patient that has not had any face-to-face service from you (or another physician of the same specialty in your practice) for the past three years.  It is irrelevant that the first visit was a consultation and they came back on their own the second time.

*This response is based on the best information available as of 11/01/18.

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