An Update on New vs. Established Patients

David Stern, MD Q.I read your column about new vs. established patient coding in the January Issue of JUCM. Although the information provided was correct at one time, I believe that Medicare has updated its algorithm to come closer to the algorithm provided by AMA for new vs, established patients. A.You are correct. In a somewhat obscure and rarely referenced information release. (www.cms.hhs.gov/MLNMattersArticles/downloads/MM4032.pdf) CMS did change its position on this issue. “Physicians should not that …

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Determining New vs. Established Patients for E/M Coding

Q.We are in the process of adding urgent care services to our occupational medicine clinic. How do we determine when to use a new or established E/M code for the patients who are seen for urgent care services? A.I continue to receive questions regarding the “when to code new or established patient E&M codes” conundrum, so let’s try to simplify the issue. The official CPT definition of new patient is: A patient who has not …

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ICD-9 Changes in 2008

DAVID STERN, MD (Practice Velocity) Q.I noticed that I am getting rejections for the code for fever (780.6). Do I need to add another diagnosis code to get paid? A.There are numerous separate issues related to this code: First, every year ICD-9 updates go into effect on Octo- ber This year was no exception. This code is now sub- categorized as follows: 60 Fever, unspecified 61 Fever presenting with conditions classified elsewhere 62 Postprocedural fever …

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