ljhaley@gmail.com
Networker
My admin insists "Obtaining fluid from a body cavity" listed under risk area in the MDM section as a reason to bump up an E&M from a 99213 to a 99214 on a variety of situations at my practice. (most often-pharyngitis) My office mgr I are at odds over what constitutes a "cavity". I have the medical definition-any fluid filled space in a multi-cellular organism other than a vessel, but need a more definitive answer for this situation.
Do throat culture, urine culture, nasal swab, vaginal or anal swab or Incision and drainage of abscess, TRULY qualify for "obtaining fluid from a body cavity"? The argument is oral and nasal cavities justify a TC and nasal swab. Urine, vaginal and anal swabs are obvious, and they say I&D is from the "cavity" of the abscess.
I learned "cavity" meant a more involved situation like a thorocentesis. Plus CPT seems to point to an answer-TC, UC, and everything else codes with LAB codes 800 series. The only thing that might qualify is the bladder cath to obtain the sample for the culture, as the cath is a medicine code. PLEASE fellow coders, give me some feedback so I can put this to rest! They think every time they do a TC it's an automatic bump to a "1-4". THANK YOU!!!
Do throat culture, urine culture, nasal swab, vaginal or anal swab or Incision and drainage of abscess, TRULY qualify for "obtaining fluid from a body cavity"? The argument is oral and nasal cavities justify a TC and nasal swab. Urine, vaginal and anal swabs are obvious, and they say I&D is from the "cavity" of the abscess.
I learned "cavity" meant a more involved situation like a thorocentesis. Plus CPT seems to point to an answer-TC, UC, and everything else codes with LAB codes 800 series. The only thing that might qualify is the bladder cath to obtain the sample for the culture, as the cath is a medicine code. PLEASE fellow coders, give me some feedback so I can put this to rest! They think every time they do a TC it's an automatic bump to a "1-4". THANK YOU!!!
