Pediatric Coding Alert

Question: In a recent issue of Pediatric Coding Alert, you advised coders to report "an outpatient established patient E/M code (9921x)" for a particular visit. Can you please tell me where I might find this code so I can report it?

North Carolina Subscriber

Answer: The letter "x" is a placeholder -- when selecting the most accurate code for your outpatient established patient E/M visit, you will replace the "x" with a number from the 1 through 5 range, meaning that your final code will be 99211, 99212, 99213, 99214, or 99215.

In cases where subscribers don't send Pediatric Coding Alert their complete medical record dictation, our editors can't accurately determine which code from the 99211- 99215 range best suits their circumstances, so we simply use an "x" to fill in the final number in the code. Once you read your practitioner's documentation, however, you should be able to select the appropriate office visit code based on the documented history, exam, and medical decision-making.