Questions for Dr. Stern
About Your Urgent Care Center
40. I am a new coder for an Urgent Care located in Texas. I am excited about learning anything and everything about urgent care. Thank you for the article on when to use the modifier 25. Very helpful!! My question is this: I have heard that under an urgent care setting we should bill for new patients only. That we should not have established patients. Let me explain. If I have a patient that came in for acute sinusitus as a new patient and then comes in the next month for a dislocated elbow; is he a new patient again, or an established patient? Of course if a patient has a procedure done that has global days, his subsequent visit would be as an established patient. Thank you in advance for sharing your wisdom.
What you have heard is a common misperception. You may only use this new patient for new problem (problem-based coding) with payors that have agreed to this method of coding. Never use for Medicare/Medicaid. You may read more by clicking here.
