Wiki Can anybody answer

Create Wiki
debipbarik

debipbarik

Networker
Messages
34
Location
Cuttack, Odisha
Best answers
0
In psychiatric evaluation if physician documented adequate HPI as Exapnded problem focused,chief complain, 1 pertinent PFSH but did not documented any ROS other than Psychiatric, then what will be the level of HISTORY?
If in above case psychiatric exam is problem focused(1-5 bullets) and MDM is of moderate complexity, what level of office visit we will code for a Established patient?

I will be very thankful if anybody helps in above case.:):)
 
History would be Expanded Problem Focused on your first example.

As far as over all level on an established patient you would have EPF history and PF exam with moderate MDM so you are limited to a 99213.

Laura, CPC, CPMA, CPC-I, CANPC, CEMC
 
The level of history would be expanded problem focused. If the exam is then problem focused and the MDM is moderate your established level would be 99213. Two of the three key elements must meet or exceed the requirements for the level.

Here's a link to the CMS Evaluation and Management Services Guide, I find this booklet very useful and refer to it often. I would also recommend using the Psychiatric Single system Exam if you're not already using it.
http://www.cms.gov/Outreach-and-Edu.../downloads/eval_mgmt_serv_guide-ICN006764.pdf
 
You must log in or register to reply here.
Top