CatchTheWind
Guest
If the provider does a minor procedure (such as destruction of an AK) at the same time as an E/M for another problem, I know that the rule is to subtract out the components that pertain to the procedure. Thus, it is obvious that the HPI and MDM pertaining to the AK will not be counted.
But what about the exam of that body system or area? Let's say the AK was on the left arm, and the patient also had a rash on the face. The provider examined the entire body (presumably to see if the rash was anywhere else). If you are coding for a skin exam, do you have to subtract the "left upper extremity" from the exam points, since the left arm had to be examined in order to remove the AK? Or is it okay to count it because it also had to be examined to rule out rash?
But what about the exam of that body system or area? Let's say the AK was on the left arm, and the patient also had a rash on the face. The provider examined the entire body (presumably to see if the rash was anywhere else). If you are coding for a skin exam, do you have to subtract the "left upper extremity" from the exam points, since the left arm had to be examined in order to remove the AK? Or is it okay to count it because it also had to be examined to rule out rash?