How often can a patient be considered 'new' for the purpose of coding?

A patient can be considered 'new' for the purpose of coding if they haven’t been seen in the past three years. This time frame is significant because it differentiates between established and new patients based on the continuity of care and the physician-patient relationship. If a patient has not been seen for this period, the provider can code the visit as a new patient encounter, which often allows for a higher reimbursement rate.

This concept helps healthcare providers accurately document and bill for their services, ensuring that the proper level of care and attention is reflected in the coding. Understanding these definitions in terms of coding is critical for maintaining compliance with billing regulations and optimizing reimbursement processes.