New Patient, or Not?

New Patient, or Not?

October 31, 2019

Question:

If I see a new patient in consultation for a suspicious skin lesion and release them to their primary care provider and they come back to see my partner for eczema one year later on their own, can she report the encounter as a new patient visit?   We are the same specialty and bill under the same tax id number.

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 the patient came back on their own the second time, or that the patient saw you the first time and your partner the second time.  It does not change the fact that the patient is established to the practice.

*This response is based on the best information available as of 10/31/19.

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