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Hi All,
It is Okey to bill for 99213 if the Physical Exam is ONLY the Vitals ?=BUT =the notes do have a complete HPI, ROS and ASSESSMENT with TX. because we have a provider in which she don't document PHY. EXAM. for ALL her 99213 visits.
established patient encounters are based on 2 out of the 3 key components, however if history is only brought forward from a previous encounter then it cannot count. So theoretically a 99213 can be based on only history and MDM but it should not be the norm.