Advanced Search

Podiatry Coding & Billing Alert

Evaluation and Management:

99212 or 99213? MDM Level Is Key to Understanding Podiatry E/M Claims

Published on Mon Jun 18, 2012

Hint: Assign tips to each of the 3 MDM components your podiatrist performs. Your podiatry practice most likely sees its share of diabetes patients, and patients with diabetes can present podiatrists with some of their most complex cases. If you're not properly evaluating the level of medical decision making your podiatrist is performing for these patients, you're at risk of undercoding the services -- and losing deserved reimbursement in the process. Diabetes patients are regular fixtures in podiatry offices, but many podiatry coders fail to code the correct E/M level for these visits because they don't properly evaluate the level of medical decision-making these more medically complex patients require. The problem: Assessing the history and exam components of an E/M is fairly straightforward, but medical decision-making (MDM) is complex -- requiring you to asses three separate categories: number of diagnoses/management options (minimal, limited, multiple, extensive) amount and complexity of data (minimal, limited, [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Podiatry Coding & Billing Alert

View All