Wiki 2 hr observation

[Alicia Scott]

I was asked about a case where a patient was not seen in the past 5 yrs and came to the office for high B/P. He was given clonidine (pill form) and observed for 2 hrs. The patient was a self pay and the doctor wished to use a code for an established patient so he wouldn't be charged as much.

This is just a scenario I was asked about. What in the world would you code for that?

 

[DeeCPC]

I was asked about a case where a patient was not seen in the past 5 yrs and came to the office for high B/P. He was given clonidine (pill form) and observed for 2 hrs. The patient was a self pay and the doctor wished to use a code for an established patient so he wouldn't be charged as much.

This is just a scenario I was asked about. What in the world would you code for that?

A new patient code 99201-99205 based on documentation. I would not code established for reimbursement or any other reason if it clearly should be coded as a new patient. PERIOD. A provider has control over how much information is documented in the note. However, if they document a note with minimum information so a low e/m is billed and the patient gets sicker (high B/P leads to heart attack or stroke) they open themselves up for malpractice type issues.

 

[Alicia Scott]

Thank you

I have talked to the nurses and think that I explained it enough. I appreciate your comments. Many small offices I think feel they are not going to be audited because they are small but that is not true.