mconner001
Guest
Hi,
We have a discussion going at our office. AMA defines a problem being addressed or managed when it is evaluated or treated at the encounter by the physician reporting the service.
If a patient comes in because our physician wants to evaluate the patient for risk due to comorbidities, say severe COPD for example, in her review or evaluation of the patient she decides that the procedure must be done at the hospital due to the high risk to the patient from the COPD. Would you say this is being 'evaluated' by AMA guidelines and bill the diagnosis code for the COPD as prime and the Z86.010 as second?
We are aware of the Medicare vs Commercial aspect of this situation.
We have a discussion going at our office. AMA defines a problem being addressed or managed when it is evaluated or treated at the encounter by the physician reporting the service.
If a patient comes in because our physician wants to evaluate the patient for risk due to comorbidities, say severe COPD for example, in her review or evaluation of the patient she decides that the procedure must be done at the hospital due to the high risk to the patient from the COPD. Would you say this is being 'evaluated' by AMA guidelines and bill the diagnosis code for the COPD as prime and the Z86.010 as second?
We are aware of the Medicare vs Commercial aspect of this situation.