The document provides a comprehensive guide on distinguishing new from established patients in medical billing, highlighting that new patients haven't received services in the last three years. It details the different CPT code levels for new patient visits (99202 to 99205), emphasizing required documentation and complexity for each. Additionally, it discusses the dynamics of group practices and the importance of accurate coding for reimbursement and patient satisfaction.

1. Mastering New
Patient CPTCodes
www.medicalbillingwholesalers.com
A Comprehensive Guide

2. Distinguishing new from established patients has
evolved.
A new patient hasn't received services in the last
three years.
while an established patient has the new patient
code range mandates meeting all three key
components, unlike the established patient
range.
Navigating
Newvs.Established
PatientDynamics

3. Level 2 new patient visit
20 minutes typical duration
Low medical decision-making
Documentation: Expanded problem-focused history
and exam, straightforward complexity.
CPTCode99202
Level 3 new patient visit.
30 minutes typical duration.
Moderate medical decision-making.
Documentation:Detailed history and exam, low
complexity.
CPTCode99203
Unravelingthe
NewPatientCPTCode

4. Level 4 new patient visit.
45 minutes typical duration.
High medical decision-making.
Documentation: Comprehensive history and exam,
moderate complexity.
CPTCode99204
Level 5 new patient visit.
60 minutes typical duration.
Comprehensive medical decision-making.
Documentation: Comprehensive history and exam, high
complexity.
CPTCode99205

5. Professional Services
Unveiled
Professional Service
encompasses face-to-
face medical services
reported by specific CPT
codes, crucial for
determining patient
status based on services
provided within the last
three years.
Deciphering'Professional
Services&GroupPractice
Nuances
Group Practice
Dynamics
In group practices,
defining a 'new patient'
can be intricate,
especially when a
patient has seen another
provider within the same
group, with specialty
designation as a critical
factor.

6. Documentation Adjustments.
1.
Reimbursement Considerations.
2.
Patient Satisfaction and Retention.
3.
NuancesAffecting
PracticeOperations
The new patient CPT code range requires
constant awareness and precision in coding to
ensure high-quality care, maximize revenue
opportunities, and ensure meticulous
documentation.

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