# E & M coding help  please



## thrower4899 (Feb 15, 2016)

Please help with correct E&M code

new patient office visit an expanded problem focused history,
comprehensive exam
MDM of high complexity

what will the E & M code become


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## CodingKing (Feb 15, 2016)

since you need 3 of 3 for new patient the best you can get is 99202

Exam and MDM meet or exceed for all levels but Expanded problem focused history doesn't go over level 2 so that is the highest you could go. If it were established patient it would be a level 5.


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## thrower4899 (Feb 15, 2016)

*E & M coding*

Thank you

so if we had 

emergency room visit with a problem focused history
comprehensive exam and 
MDM of high complexity 

would the code become a 99283 or 99284


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## trose45116 (Feb 26, 2016)

I was told that when you need 3 of 3 you code to the lowest and when you need 2 of 3 you drop the lowest and code to the second lowest.


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## bedforak1 (May 11, 2016)

For the Emergency Room visit, the highest you could get is a 99281. You have to meet 3 out of 3 components


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## mk386 (Jul 18, 2016)

*Can anyone answer with explanation.....*

The patient is a 35-year-old male who presents to the emergency department (ED) after several hours of low back pain, nausea, and chills. The ED physician takes a detailed history and performs a comprehensive examination. A urinalysis lab and CT of the abdomen is ordered. The results of the CT show two small kidney stones. The ED physician discusses the results with the patient and tells him the stones are small and will pass on their own. Medical decision making (MDM) of moderate complexity is made with the patient being discharged, with a prescription of pain medication, and with a diagnosis of kidney stones. Select the E/M code and diagnosis code(s).
1. 99283, N20.0
2. 99284, N20.0


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## sujaya101 (Jul 18, 2016)

Seems like it's fr exam purpose. If you look up ER visits in your CPT book and match it with the criteria like detail history, comprehensive exam etc, you will find the answer. Preparation for exam is different than real life EM coding. I would look up both these codes and see which one matches. In real life, you would have to determine if the history is detail or if  the exam is comprehensive and then determine the level of service. For exam those are already given to you.


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## freseniusj@gmail.com (Jul 24, 2016)

*E/M is Hard!!*

Does anyone have tips for coding E/M services.
I don't know if I overthink things. Does everyone chart it all out when figuring out the levels of history, exam and MDM or do you do it more simply?
ANY advice would be so so helpful.


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## danskangel313 (Jul 25, 2016)

mk386 said:


> The patient is a 35-year-old male who presents to the emergency department (ED) after several hours of low back pain, nausea, and chills. The ED physician takes a detailed history and performs a comprehensive examination. A urinalysis lab and CT of the abdomen is ordered. The results of the CT show two small kidney stones. The ED physician discusses the results with the patient and tells him the stones are small and will pass on their own. Medical decision making (MDM) of moderate complexity is made with the patient being discharged, with a prescription of pain medication, and with a diagnosis of kidney stones. Select the E/M code and diagnosis code(s).
> 1. 99283, N20.0
> 2. 99284, N20.0



You need to meet 3 of 3 criteria when leveling an ED visit. If any one of the components does not meet a particular level, then it's not valid. The CPT book explains this in detail at the beginning of the E/M section. You also need to watch your diagnoses. N20.0 might not be the only code to use.


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## Sensory (Sep 8, 2017)

*E/M Levels:  New and Establilshed Patient Coding Examples*

View attachment EM New and Established Patient Examples.pdf

Working with multi-specialty providers, I am often asked for point of reference examples.

Feel free to reference the attachment as needed.


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