Wiki E&M level for pain management

[cward267]

Hello,

I'm reviewing an ov for coder at a pain management clinic.
The visit was charged out as a 99204, but needs to be an est visit.
I reviewed the chart and am only coming up with a 99213....
Are the guidlines for the OV the same as would be for general practice? Can I use time based?
Any where to find a e&M coding guidelines or audit sheet for PM?

Thanks for your help!
Carolyn

 

[OCD_coder]

'

E&M Guidelines apply the same to all specialties. Depending on the complaint you could use one of several different Exam Templates from the '97 DG; Multi-system, Musculoskeletal or maybe Neuro; whichever is most beneficial to the provider. The Marshfield Audit Tool is recognized by most carriers and it usable with Pain Management as E&M is not specialty specific.

You can use time is the documentation meets the criteria.
1. Total time must be documented.
2. Total time spent counseling, coordinating care.
3. Describe the discussion with the patient in sufficient detail to support selecting the level based on time.

Simply stating "Discussed treatment options" is insufficient to meet MCR standards.