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Ob-Gyn Coding Alert

Up Your E/M Dollars by as Much as $49 by Reassessing Risk Level

Published on Wed Jun 17, 2009

Note: Medical decision making involves more than just risk. Not certain how to calculate a patient's risk level? You could be guilty of undervaluing your ob-gyn's medical decision making and downcoding E/M visits. When the difference between a new-patient level-three and -four code is $49.77, that missing money could add up. Warning: Some ob-gyn coders misinterpret the level of risk associated with the physician's care plan. They assume that the doctor must meet the criteria for all three categories of risk: presenting problem, procedure(s) ordered, and management option(s) selected. But a single bulleted item, and the item's position in the table,determines the level of risk. Determine Minimal, Low, Moderate, and High Reqs You should follow Medicare's Table of Risk to select the patient's correct risk of complications. Note: CMS published the Table of Risk as one of seven tables in the 1995 and 1997 E/M Documentation and Coding Guidelines. Medicare [...]
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