Coding Corner Answer

Take the Quiz.

1. A. This patient would be an established patient for Dr. Clark because it has been less than three years since the patient’s last visit, because Dr. Clark and Dr. Baker are partners, and because Dr. Clark would have access to the patient’s medical record. It would not be a consult because Dr. Baker did not ask for Dr. Clark’s medical opinion or advice.
2. A. This would be an established patient for Dr. Green because she was seen by another physician in Dr. Green’s practice within the last three years. It would not matter that Dr. Green had not seen the patient. It would not be a consult because Medicare has eliminated all consult codes as of January 1, 2010.
3. B. This would be a new patient even though the patient was seen by another physician in the same practice. This is because the practice is a multispecialty practice, and the other physician was from another subspecialty. Again, this could not be a consult because this is a Medicare patient.
4. A. This would be an established patient. Dr. Black has seen the patient within three years; it does not matter where he saw the patient. What matters is that he saw the patient within the last three years.
5. A. This would be an established patient. The partner is of the same specialty and as long as Dr. Smith has seen the patient within three years, the patient is considered established to everyone in the practice.