Ladymed
New
I have come across more information of each component of E/M coding. I was hoping someone could offer a little more clarification on two points. See below:
Question 1:
HPI: 1995 vs. 1997 guidelines; big difference is the acceptance of chronic conditions being counted in this section (1997 guidelines). A state's CMS website has the below statement:
"An extended History of Present Illness (HPI) may consist of the status of three chronic/inactive conditions for either set of guidelines (1995 or 1997) for services performed on or after on or after September 10, 2013"
Is this correct? My office uses the 1995 guidelines for leveling E/M's and need to know if the 1995 guidelines now accept chronic conditions for HPI evaluation.
Question 2:
Medical Decision Making - Data ordered/reviewed:
AAPC E/M presentation says that if a diagnostic test is separately billed than the ordering/reviewing of said test cannot be counted in the data section of MDM.
Here's my example:
If Dr. A is part of Practice ABC and orders/bills for an EKG. Then at a later date Dr. B (under the same practice) see this patient and in his E/M note says he reviewed previous EKG. If Dr. B neither ordered or billed for the EKG can this data be counted? Or since the EKG was billed by a practice that both physicians fall under it is still double dipping?
I appreciate any enlightenment given.
Thank you.
Question 1:
HPI: 1995 vs. 1997 guidelines; big difference is the acceptance of chronic conditions being counted in this section (1997 guidelines). A state's CMS website has the below statement:
"An extended History of Present Illness (HPI) may consist of the status of three chronic/inactive conditions for either set of guidelines (1995 or 1997) for services performed on or after on or after September 10, 2013"
Is this correct? My office uses the 1995 guidelines for leveling E/M's and need to know if the 1995 guidelines now accept chronic conditions for HPI evaluation.
Question 2:
Medical Decision Making - Data ordered/reviewed:
AAPC E/M presentation says that if a diagnostic test is separately billed than the ordering/reviewing of said test cannot be counted in the data section of MDM.
Here's my example:
If Dr. A is part of Practice ABC and orders/bills for an EKG. Then at a later date Dr. B (under the same practice) see this patient and in his E/M note says he reviewed previous EKG. If Dr. B neither ordered or billed for the EKG can this data be counted? Or since the EKG was billed by a practice that both physicians fall under it is still double dipping?
I appreciate any enlightenment given.
Thank you.