Wiki ED level for prescription refill only

[annierevt]

ED EM pro fee levelling question... patient presents to ED for prescription refill as he doesn't have a PCP. He presents every month for the same refill of his BPH med. No workup or eval done due to patient being a known patient. No other PMH so no chronic conditions and not on other meds. I coded to a level 2 based on no evaluation or workup, no tx given and just a script. It came back after audit as an error saying it should be a level 3. Thoughts?

 

[jessica7307]

ED EM pro fee levelling question... patient presents to ED for prescription refill as he doesn't have a PCP. He presents every month for the same refill of his BPH med. No workup or eval done due to patient being a known patient. No other PMH so no chronic conditions and not on other meds. I coded to a level 2 based on no evaluation or workup, no tx given and just a script. It came back after audit as an error saying it should be a level 3. Thoughts?

I would agree with 99283 for the pro and a 99281 for fac if it's just a refill

 

[swiftlaureen@gmail.com]

I would agree with 99283. BPH is a chronic condition so the Complexity is Low due to one stable chronic illness. Nothing in Data. But Risk is moderate because RX written. 1 low +1 moderate = 99283