amexnikki23
Guest
I have an EM guideline sheet developed by 'E/M University' that our practice utilizes; it's basically the same as the CMS EM guidelines. In the risk table it gives insect bites as an example of a self-limited or minor problem, yet every provider I audit for (10+ providers) consistently use a 99213 each and every time, and will even use a 99203 on a new patient. I can justify this when maybe inflamed, warm to the touch possibly infected, some labs run for suspected viruses, etc. but in the case of a simple insect bite, no tests run, no signs of infection of imbedded stingers or bug parts, etc., wouldn't this just be a straightforward MDM with minimal risk? Our providers almost NEVER ever code a 99212. Just wondering if what others are seeing out there. Thanks!