e/m coding

  1. A

    Wiki Can 99222 be billed twice on the same DOS?

    DOS is 1/12/23. A psychiatrist billed 99222 for the consult he had in collaboration with an APP.. Three hours later a neurologist consulted in collaboration with her APP and also billed 99222. The neurology consult was denied. Should I just rebill it and append modifier -25 to it? Please advise.
  2. S

    Wiki E/m section question

    Someone please help me with this question. A 55-year-old established patient is coming in for a pre-op visit; he is getting a liver transplant due to cirrhosis. The physician performs an expanded problem focused history, detailed examination, and moderate MDM. Patient agrees with his...
  3. K

    Wiki Dog bite -E/M MDM complexity w/procedure?

    Would love some feedback on what level of complexity you would code dog bites. Would you see this as a level 3 or 4 E/M in addition to the 12001 procedure that was fully documented? Summary points: Patient presents with 2.5 cm open wound closure measured on hand due to dog bite. Simple closure...
  4. firetorah

    Wiki Nutrition/Diabetes Counseling Group E/M visit

    OK, here's the deal: I have a physician and a Registered Dietitian who wish to hold group nutrition and/or diabetes counseling sessions. Let's assume the session is 30 minutes long and involves 10 patients. This is their scenario: The physician wishes to charge each patient with an E/M...
  5. A

    Wiki Psych Clinic- Number and Complexity of Problems Addressed

    I am new to coding for psych providers and I was wondering if I could get some guidance on determining the number and complexity of problems addressed. What happens when a patient has anxiety and depression that is managed by meds? Would that be a 99213 (low presenting problem) or 99214...
  6. J

    Wiki E/M coding General SX looking for Help

    Looking to talk to someone for some help to determining level of E/M for H&Ps general SX. The provider uses a level 5 a lot and I feel that they are 4s at best. I am looking for a little guidance to help me feel more confident in my decision as I am new to gen sx and still grasping E/M coding. I...
  7. K

    Wiki E/M and Procedure same day, New patient

    If a patient is referred to us for Epistaxis R04.0 and we have never seen them before, we do the E&M and it is decided that the patient needs a scope. Can we bill a new patient visit and a scope on the same day 99204 with a 25 modifier 31231 Nasal Endoscopy?
  8. X

    Wiki Visits by Pulmonologist in SNF

    Hello everyone. I have a question. When a specialist provider visits a resident in Skilled Nursing Facility, what E&M code to use? Would it be from SNFs 9930-99306, 99307-99310 or from OV 99202-99205, 99212-99215? I know that Medicare no longer pay for consultations. Appreciate any input guys!
  9. N

    Wiki Preventative visit with additional coding

    I have a medical chart where patient came in for "well woman" exam; however medications were ordered for Asthma, Anaphylaxis, and Seasonal allergies. Provider goes over the asthma briefly in the subjective part of the encounter - then goes over all 3 within the "plan" part of the encounter -...
  10. M

    Wiki Help!! 99211 and Lab Only

    Hello coders! Can anyone please advise and clarify how and when to use and bill a 99211 for lab only services. We generally use 99211 for nurse f/u and lab visits on established patients. The RN's are doing STD exams and coding only the 99211. The CMA is doing the collection. Some of our...
  11. M

    Wiki Billing E/M codes - new vs established

    Hello coders! If a patient has been seen in the same clinic for GYN with a different doctor and returns for a different program service area (STD) and different doctor.... how would this be coded? New or Established? My thoughts it would be coded as an established visit regardless of what...
  12. J

    Wiki Percentage distribution for E/M levels

    Please help!! My boss and his bosses are telling me that the percentage for level 4's both new and established patient should be at 80% for urgent care centers. AAPC has a E/M benchmarking tool where you can enter your number of visits for each level and it will tell you what your percentage...
  13. A

    Wiki How is this should be coded? (OB/GYN OUTPATIENT)

    Hi guys! Can you please help me to code this ob encounter? Scenario: An established patient visited the clinic for her initial antenatal care. She is currently 15 weeks pregnant (G2,P1) with previous cesarean section due to breech presentation. This is a spontaneous pregnancy. Patient has...
  14. S

    Wiki ER Consult Coding Clarification

    Hello Everyone! I hoping I can find some help in a situation that has come up with correct coding. So the scenario is as follows: ER doctor (Dr. A) calls in my physician (Dr. B) for a consult. Dr. B sees the patient in the ER and after this consult Dr. A decides to admit the patient. Dr. B...