As of January 1, 2012, CPT will change its definition of what constitutes a new patient. In the past it read that a new patient was one who hadn’t received any professional services from any physician of the same specialty who belonged to the same group practice, within the past three years. In January the definition will read that a new patient is one who hasn’t received any professional services from a physician of the exact same specialty and subspecialty in the past three years.
This means that if a patient has seen an OB/GYN or GYN generalist, she would still be considered a new patient the first time she saw one of our subspecialists. Also, if a patient saw a subspecialist and was then sent to a generalist, she would still be a new patient.
If you have any questions or comments about this topic, please contact your clinic coder or Coding Coordinator, Marcia Yochum.