Did you determine whether the patient in each of the following scenarios is considered new or established to the treating physician?

Dr A provided interpretation and report of an electrocardiogram for a patient in 2021. In 2022, Dr A receives a request to provide a telephone E/M service to the patient to whom Dr A has provided no other services. Does Current Procedural Terminology (CPT®) prohibit reporting the telephone E/M code for Dr A’s service to this patient? Yes

Rationale: The patient is new to Dr A because there has been no face-to-face service to establish the patient with Dr A. Although payers may adopt a policy to allow new patient telephone E/M services, CPT instructs that telephone codes are reported for episodes of patient care initiated by an established patient or guardian of an established patient.

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