AmandaW
Guru
If need only 2 out of 3 for established patient, can exam be totally thrown out? Not documented at all....but complete history and MDM....I can count that as a 99214 as long as those two elements meet the criteria?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki if need 2/3 for established.....
- Thread starter AmandaW
- Start date
ellzeycoding
Guest
- Messages
- 392
- Best answers
- 0
One of the three components can be deficient for established patient E/Ms... So, let's say you need 12 or more bullets for exam to meet 99214, but had only 8, but were OK in meeting the criteria for history and MDM, then you could still select 99214.
twizzle
Guest
Yes, you can disregard a PE if you only need 2/3 for an established patient. However, what do you mean about a complete MDM?.... there is no such thing.
MDM options are SF, low, mod or high and it is the MDM that ultimately drives the level. If you have a comprehensive history and EPF exam you have 99213.
Perhaps you can provide the documentation so we can advise you further.
AmandaW
Guru
Sorry, I meant 'complete' meaning, the MDM componets meet the level that the physician wishes to bill.
But, what if I have a comprehensive history and a comprehensive exam, but lacking in the MDM componets. Only need 2 out of 3, but
MDM HAS to be one of them, right?
But, what if I have a comprehensive history and a comprehensive exam, but lacking in the MDM componets. Only need 2 out of 3, but
MDM HAS to be one of them, right?
Pathos
True Blue
MDM is the driver, History/Exam is the passenger.
At our practice, the MDM should be the driver of the visit. This means that the MDM has to be one of the 2 which determines the E/M level, the other component would be either the History or Exam.
So to answer your question above, if documentation supported a Complete History and a Comprehensive Exam, but only a Low Complexity MDM, the level would be 99213.
Hope that helps!
At our practice, the MDM should be the driver of the visit. This means that the MDM has to be one of the 2 which determines the E/M level, the other component would be either the History or Exam.
So to answer your question above, if documentation supported a Complete History and a Comprehensive Exam, but only a Low Complexity MDM, the level would be 99213.
Hope that helps!