Wiki E/M code in the follow-up peroid

[jemimah crescentia]

Hi:

Could anyone let me know whether an established E/M code(99211-99215) can be coded in the follow-up period(within 7days) if the patient returns to the same doctor with different complaints than the previous,(e.g., patient was consulted 5 days back for asthma & respiratory problems and now presented with new complaint of stomach pain & gastro problems),

Thanks in advance

Dr.Jemimah, CPC

 

[OCD_coder]

It sounds like you may not be in a global period as a procedure was not performed at the 1st encounter. A provider can see a patient for any medically necessary reason, meaning an E&M is a billable service for that criteria as there is no frequency limitations in the guidelines, except two E&M's on the same day (not acceptable).

If a procedure was performed on the 1st encounter that has a global period whereby the 2nd encounter falls into, then a modifier 24 would be appended to the 2nd encounter so that it shows insurance that the reason for the visit was for completely different complaints.

 

[jemimah crescentia]

Thanks for your reply and clarification....