Wiki Dx. 042 Level of Service?

[veloso]

Hi all,
We are an Article 28 clinic where 90% are HIV patients and I was asked if possible we will code all our NEW patients to 99205? and the follow-up which is every 3-4 months to 99214? Am I not a risk to be audited? NEEDS HELP PLS.

Thanks

 

[mitchellde]

you code the level of service to what the documentation will support with the medical necessity being the over riding criteria. No diagnosis is an automatic level 5 or 4 or any other level. The providers documentation of the level of care provided as required by the severity of the patient's condition is what will determine the level of service submitted. IF they are all level 5 and 4 and you can support that each time, then do not fear being audited.