Brenda Ray
Guest
If the Physician fails to meet the 3 out of 3 required criteria for a NEW office patient, is it appropriate to downcode this to an ESTABLISHED office visit? This particular Physician only met 2 out of the 3 required elements...he did NOT do an Exam on a NEW patient and did not document any time factor either. I think it is unbillable but we have been told to downcode it to the ESTABLISHED visit (only 2 out of 3 have to be met) even without the Exam????? I find that hard to believe because for a NEW patient, there should definitely be an Exam and History and MDM for sure.
Thanks for your help in advance!
Thanks for your help in advance!