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Billing for 1 Doctor under 2 different tax id's
One of our Doctors was called in for a stress test at an out patient hospital. This was billed under one tax id and this processed and paid. The patient then came back for an office visit for this same Doctor, but the tax id is different and the Doctor never saw the patient prior except for being there when the stress test was done. I needed to know if we would bill as a new office visit or an established patient. Please let me knpw when you can.
Thanks so much
Beth
Billing for 1 Doctor under 2 different tax id's
According to CPT®, Determination of a Patient's statue as new or established is below:
"Solely for the purposes of distingushing between new and established patients, professional services are those face-to-face sercices rendered by a physician and reported by a specific CPT® code (s). A new patient is one who has not received any professional services for the physician or another physician of the same specialty who belongs to the same group practice, within the past three (3) years."
Because your physician has had face-to-face time with this patient within the specified three year time frame, I would bill the encounter as established. The tax ID is irrelevant as code assignment has nothing to do with tax ID #.
professional service
If a professional service was rendered face-face within 3 years--it is an established patient