In this scenario for the office visit, are we billing for a New Patient encounter
or an Established Patient encounter? Please help.
Per CPT guidelines, "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 last 3 years".
So based on this guideline, if the patient was already seen by the physician
from the hospital, obviously it means you must bill the office visit as
established" patient. If you need additional information on this guideline,
see your CPT code book.