Posted and filed under Coding.

Your group just merged with another practice, are these considered patient’s new or established?

With mergers and acquisitions so frequent in the healthcare industry, it’s important to be aware when faced with these issues and knowing what to do with your patients when going through this transition.

A few key questions to help determine this include the following:

  • Has this physician seen this patient for a face-to-face service in any setting, within the past three years?
  • If you are in a group practice, has another physician of the same specialty who belongs to your group practice (billing under the same tax ID number) seen this patient for a face to face service within the past three years?

If you answer “no” to both of the following questions audit and submit the supported new patient code.  Remember face-to-face does not mean your provider or other qualified healthcare professional interpreted a diagnostic test.  Face-to-face most often means an evaluation and management or surgical service.

Have further questions about this? Feel free to contact us.