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Q&A Free screening & "new" patient

Laurie Johnson

New Member
Our medical group offers numerous free screenings. These screenings consist of having the patient complete a 2-3 page questionnaire and then does see the physician. The questionnaire is scanned into the EHR but that is the sole extent of documentation for that visit. If the physician sees something he/she thinks needs follow-up the patient makes an appointment for another visit.

The question is -- is the patient considered "new" or "established" when he/she comes back for the first actual paid visit?
 

Lori Woods

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CPT DEFINITIONS
New and Established Patient
Solely for the purposes of distinguishing between new and established patients, professional services are
those face-to-face services rendered by a physician and
reported by a specific CPT code(s). A new patient
is one who has not received any professional services
from the physician or another physician of the same
specialty who belongs to the same group
practice, within the past three years.
So if you were able to bill any codes on the first visit as they did see the Dr. face to face I am guessing Established, but if there was nothing billed the first time I am wondering if it would count because technically would a service have been rendered if the Dr. is not coding a claim is just the documentation enough to be considered an examination I don't think so so I would say New if there was no code billed the first time.
The extent of the examination performed is dependent on clinical judgment and on the nature of the
presenting problem(s). There was no problem to begin with unless the Dr. sees something then he is billing for that visit maybe?
 
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