My physician seen a previous patient in the clinic who was last seen in 2015. He selected 99204, but the claim was denied stating new patient qualifications were not met. When I asked him about this, he stated it was an error on his part because he thought it was 2 years not 3 years when deciding new vs. established. So now I need to submit a corrected claim.
I watched an E/M leveling video on YouTube recently and now I'm wondering how do I go about selecting the correct established patient code. I don't feel like just switching to 99214 would be correct (maybe I'm overthinking it)
99204 = comprehensive history, comprehensive exam, & mdm is moderate, 45 mins
99214 = detailed history, detailed exam, & mdm is moderate, 25 mins
99215 = comprehensive history, comprehensive exam, & mdm is high, 40 mins
My gut says it should be 99215.
Thanks in advance!!!
Tammy
I watched an E/M leveling video on YouTube recently and now I'm wondering how do I go about selecting the correct established patient code. I don't feel like just switching to 99214 would be correct (maybe I'm overthinking it)
99204 = comprehensive history, comprehensive exam, & mdm is moderate, 45 mins
99214 = detailed history, detailed exam, & mdm is moderate, 25 mins
99215 = comprehensive history, comprehensive exam, & mdm is high, 40 mins
My gut says it should be 99215.
Thanks in advance!!!
Tammy