For coding purposes, a new patient is one that has not been seen by you or any other OD in the practice within the last three years. That means if you are seeing a patient you last saw five years ago and that patient has not seen another OD in the practice within that time frame, you are entitled to use “new” patient codes on the claim. And that is significant because “new” patient codes often reimburse better than “established” based on the idea that more time is required to document/update the patient’s history, etc.
So, if you are seeing a patient that you have seen before but she meets the coding definition of a “new” patient, it is proper to use a “new” patient code for the office visit.