eval & management

  1. K

    Wiki Too many DX Codes for Medicare?

    I have a physical therapist wanting to submit a claim to Medicare with 6 DX codes for their evaluation (97163 GP & 97110 GP). Their primary diagnosis is G35 (MS) but the provider has also added M21.372, M54.6, M54.59, M25.552, M25.562. I am worried this will lead to a denial. Thoughts?
  2. S

    Wiki No insurance, EM+ procedure

    Hi, Our practice wants to offer discount rates on office visits and procedures for those patients without insurance. We have a concern on billing correctly. Example: If filing insurance: A procedure is performed (no separately identifiable EM) then only the procedure would be billed to...
  3. 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...
  4. C

    Wiki 2021 MDM: Procedure Risk Factors

    What would you identify as a procedure risk factor? Is it the documented inherent risks of the procedure? Please provide supporting references if possible.
  5. S

    Wiki New Patient/ Flu only but coding a level of service

    For this flu season I am seeing new patients who are only coming in to receive a flu shot having to book an office visit with a provider. They are dropping a level of service code (E&M code EG: 99201-99205), the flu vaccine and the flu administration code. The patient has no chief complaint or...