kathymoon
Guest
I have just begun some training with our Hospitalists, who currently are not coding their visits. We have a CPC who doing the actual coding at this time. So as I review their records I am curious how you would decide the Medical Decision Making on the following case. There seems to be some discrepancy between my code and the CPC's. I'll keep it as brief as possible. This is for the admission day.
Reviewed CT-scan of abdomen (showed bilateral hydronephrosis)
History of previous kidney stones.
1. Obstructive kidney stone, bilaterally
a) Admitting physician spoke directly to urologist for his recommendations and planning stent placement in the morning.
b) IV fluids and IV Dilaudid for pain
2. Acute renal failure probably secondary to hydronephrosis
3. Questionble inflammation around the appendix.
a) Surgeon being consulted regarding appendix
There is a Comprehensive history and Comprehensive Exam.
So who says 99222 and who says 99223?
And thanks in advance for the feedback.![Eek! :eek: :eek:](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
Reviewed CT-scan of abdomen (showed bilateral hydronephrosis)
History of previous kidney stones.
1. Obstructive kidney stone, bilaterally
a) Admitting physician spoke directly to urologist for his recommendations and planning stent placement in the morning.
b) IV fluids and IV Dilaudid for pain
2. Acute renal failure probably secondary to hydronephrosis
3. Questionble inflammation around the appendix.
a) Surgeon being consulted regarding appendix
There is a Comprehensive history and Comprehensive Exam.
So who says 99222 and who says 99223?
And thanks in advance for the feedback.
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