I had always been taught that a level 99214 visit would be the equivalent of a 99204 for a new patient. However, another coder is telling me that 99214 would actually equal 99205 for a new patient. Can anyone help clarify and direct me to documentation to support the finding? Thanks!
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Wiki Does 99214 = 99204 or 99205?
- Thread starter kgarnette
- Start date
You can't just cross over an established pt to a NP visit. You need to take the history, exam and MDM into account. See below:
A 99214 that had a Det, Det, Mod would be a 99203
A 99214 that had a PF, Det, Mod would be a 99201
A 99214 that had a Comp, Det, Mod would be a 99203
A 99214 that had a Comp, Comp, Mod would be a 99204
A 99214 that had a Det, Det, High would be a 99203
I can't even think of a scenario where the components of a 99214 could ever equal a 99205. Anyone want to try to come up with one (and remember the MDM can't exceed the level).
-Jen
A 99214 that had a Det, Det, Mod would be a 99203
A 99214 that had a PF, Det, Mod would be a 99201
A 99214 that had a Comp, Det, Mod would be a 99203
A 99214 that had a Comp, Comp, Mod would be a 99204
A 99214 that had a Det, Det, High would be a 99203
I can't even think of a scenario where the components of a 99214 could ever equal a 99205. Anyone want to try to come up with one (and remember the MDM can't exceed the level).
-Jen
You can't just cross over an established pt to a NP visit. You need to take the history, exam and MDM into account. See below:
A 99214 that had a Det, Det, Mod would be a 99203
A 99214 that had a PF, Det, Mod would be a 99201
A 99214 that had a Comp, Det, Mod would be a 99203
A 99214 that had a Comp, Comp, Mod would be a 99204
A 99214 that had a Det, Det, High would be a 99203
I can't even think of a scenario where the components of a 99214 could ever equal a 99205. Anyone want to try to come up with one (and remember the MDM can't exceed the level).
-Jen
A 99214 that had a Det, Det, Mod would be a 99203
A 99214 that had a PF, Det, Mod would be a 99201
A 99214 that had a Comp, Det, Mod would be a 99203
A 99214 that had a Comp, Comp, Mod would be a 99204
A 99214 that had a Det, Det, High would be a 99203
I can't even think of a scenario where the components of a 99214 could ever equal a 99205. Anyone want to try to come up with one (and remember the MDM can't exceed the level).
-Jen
MikeEnos
Guest
Either you didn't understand them, or they don't know what they are talking about. Jen spelled out all the possibilities above, but there is no scenario where a 99214 (which is a detailed history and exam, with moderate MDM complexity) would cross-walk to a 99205 (which is a comprehensive history and exam, with high complexity MDM.) Even based on time, a 99214 is typically 25 minutes, a 99205 is 60. Not even close.
In fact, I wouldn't even recommend your original anecdote. 99214 does not equal 99204. The complexity is the same (Moderate) but a 99214 requires a detailed history/exam whereas a 99204 requires a Comprehensive history/exam.
In fact, I wouldn't even recommend your original anecdote. 99214 does not equal 99204. The complexity is the same (Moderate) but a 99214 requires a detailed history/exam whereas a 99204 requires a Comprehensive history/exam.
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