Wiki e/m - no exam

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solocoder

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I'm sure this question has been asked and answered here before, but I am not able to find it. Can the doctor charge an inpatient e/m visit if he does not physically see the patient or speak with any family members? And does anyone know where I can find documentation on MCRs website to support the answer?
Thanks for any help.
 
EM with no Exam

For new Pt three components are needed HX, EX and MDM, if the there is no exam performed then obviously the code level will go to 99201 as three are required for new pt.

For est pt only two out of three are needed if Ex is not done then still you have two components HX and MDM, check where these two are falling and assing the level appropriately. This will happen mostly if the patient is comimg for second time or for follow-up or for just drug administration which is prescribed by the physician in the previous visit.

But some payers stick to MDM where it is a mandatory component even though the guidelines states only two out of three are needed for est pt.
 
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he must physically see the patient to charge a level of service, the initial inpatient requires an exam of the patient as well as the history and MDM, the subsequent requires only 2 out of the 3 but it is hard to justfy even a low level if there was no observation of the patient, there does not have to be an exam but even history and MDM need at least eyes on the patient.
 
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