kdbeale
New
I have a question about E&M level selection. I have a provider billing lots of claims with a DX like acute bronchitis with no documented complications and then codes the exposure to Covid DX Z20.822. The acute uncomplicated code falls into “low” but what about the possible exposure? It seems like the 2 together still fall into low for the DX criteria because the “moderate” descriptions don’t seem to fit. And would a negative or positive Covid test have any bearing on E&M level?
Update: Here's some clarification related to my ask, these claims are Urgent Care claims billing standard E&M codes, and the struggle is mostly with helping the providers understand the E&M leveling and that 2 of the 3 criteria must be met. I was focusing on the piece they were having a hard with which is the diagnoses/problems addressed versus the other 2 pieces of criteria (amount/complexity of data reviewed and patient management). The providers were not understanding that 2 of the 3 criteria had to be met so I was trying to help them understand where the DX's fell on their own accord in the "straightforward, low, moderate, high" criteria specifically.
Update: Here's some clarification related to my ask, these claims are Urgent Care claims billing standard E&M codes, and the struggle is mostly with helping the providers understand the E&M leveling and that 2 of the 3 criteria must be met. I was focusing on the piece they were having a hard with which is the diagnoses/problems addressed versus the other 2 pieces of criteria (amount/complexity of data reviewed and patient management). The providers were not understanding that 2 of the 3 criteria had to be met so I was trying to help them understand where the DX's fell on their own accord in the "straightforward, low, moderate, high" criteria specifically.
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