E/M Weekly Tip: New Patient Codes

Interpret the phrase "new patient" to mean a patient who has not received any professional services (e.g., E/M service or other face-to-face service, such as a surgical procedure) from the physician or physician group practice (same physician specialty) within the previous three years. For example, if a professional component of a previous procedure is billed in a three-year time period (e.g., a lab interpretation is billed and no E/M service or other face-to-face service with the patient is performed), then this patient remains a new patient for the initial visit. An interpretation of a diagnostic test, reading an X-ray or EKG in the absence of an E/M service or other face-to-face service with the patient does not affect the designation of a new patient.