Insurance and Medical Coding Test Prep

Category - Free Coding Specialist Practice Test

Mr. Beck was recently seen in the hospital by Dr. Johnson, who is his PCP. Dr. Johnson usually treats Mr. Beck for his stomach issues, but he has not had any problems in the last four years, so he has not scheduled any follow-up appointments. Mr. Beck was recently weed-eating in his backyard when a rock flew up and hit him in the eye. Dr. Johnson was the on-call physician, who treated Mr. Beck for his eye injury. He recommended that Mr. Beck schedule a follow-up visit the next week. Will Dr. Johnson bill the follow-up visit as a new patient or as an established patient?
  1. New
  2. Established
  3. Not enough information provided to determine patient status
Explanation
Answer: B - Dr. Johnson will bill the follow-up visit as an established patient. New v. established rules state that if a patient has not seen the doctor within three years, he is considered a new patient, but in this case, Mr. Beck saw his physician twice within a week. Although Mr. Beck did not schedule any follow-up visits with Dr. Johnson for four year, he did see Dr. Johnson that week in the ER, and as such he is once again an established patient.
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