Put Your E/M Answers to the Test
Published on Sun Jul 25, 2010
See how you fared when it comes to choosing codes.After you've read the scenarios carefully on pages 60 and decided on your answers, see how yours compares with those of our experts.Choose 99202 for Scenario 1Although the coder in this situation reported 99204, the correct answer is 99202, based on the documentation. Here's why.For the history portion, the ob-gyn went into the one-to-three required HPI (location vaginal, quality discharge, associated sign/symptom itching), listed the one pertinent ROS (denies urinary problems), and did one of three PFSH (pancreatitis). This means the ob-gyn documented the history as expanded problem-focused.For the exam portion, the ob-gyn documented a detailed examination under both the 1995 and 1997 guidelines. He performed an extended exam of affected organ system plus eight additional areas/systems, based on the 1995 guidelines. (Tip: A comprehensive exam would have required examination of eight organ systems, not a combination of body areas and organ [...]
