Orthopedic Coding Alert
Mind Descriptors When Choosing Inpatient E/M Levels
Question: Encounter notes indicated that our orthopedist performed a first-day hospital evaluation and management (E/M) service for a patient that included a comprehensive history, comprehensive examination, and low-complexity medical decision making (MDM). I reported 99222 and received a denial. Why? Tennessee Subscriber Answer: You overcoded this one. On resubmission, report 99221 (Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity …). Why? The descriptors for initial hospital care are tricky. You likely figured that the level of service covered all three components for 99222 (… A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity …). However, the visit only satisfied the history and exam portion of the required service levels. If MDM were of moderate complexity, then you could have reported 99222.
Orthopedic Coding Alert
- Injection Introduction:
Select Codes Carefully for Protection on Injection Claims
Here’s why ICD-10 smarts are key for these 3 injection services. Do you sometimes feel [...] - Medicare Policy Updates:
Proposal Pushes Uncommon Conversion Factor Cut
… but there’s good news about the covered telehealth list. If you haven’t had enough [...] - Case Study Corner:
Time or MDM? Make the Right Choice in 2021
Encounter specifics will determine better E/M factor next year. As you must know by now, [...] - You Be the Coder:
Use This Peroneal Muscle Group Primer to Choose Dx
Question: Encounter notes indicate that the provider treated a patient for “laceration, peroneal muscle group, [...] - Reader Questions:
Yes, There Is a Code for COVID-Related Expenses
Question: What do you know about the new CPT® code for reporting additional practice expenses [...] - Reader Questions:
Check Out These Quick Hits on Anatomical Modifiers
Question: I’ve been coding for about a year, and I’m getting better. One aspect that [...] - Reader Questions:
Mind Descriptors When Choosing Inpatient E/M Levels
Question: Encounter notes indicated that our orthopedist performed a first-day hospital evaluation and management (E/M) [...] - Reader Questions:
Medication Management Makes for Difficult Dx Coding
Question: Which ICD-10 code should I use for medication management? West Virginia Subscriber Answer: The [...]
