E & M coding help please

thrower4899

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Please help with correct E&M code

new patient office visit an expanded problem focused history,
comprehensive exam
MDM of high complexity

what will the E & M code become
 

CodingKing

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since you need 3 of 3 for new patient the best you can get is 99202

Exam and MDM meet or exceed for all levels but Expanded problem focused history doesn't go over level 2 so that is the highest you could go. If it were established patient it would be a level 5.
 

thrower4899

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E & M coding

Thank you

so if we had

emergency room visit with a problem focused history
comprehensive exam and
MDM of high complexity

would the code become a 99283 or 99284
 

trose45116

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I was told that when you need 3 of 3 you code to the lowest and when you need 2 of 3 you drop the lowest and code to the second lowest.
 

mk386

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Can anyone answer with explanation.....

The patient is a 35-year-old male who presents to the emergency department (ED) after several hours of low back pain, nausea, and chills. The ED physician takes a detailed history and performs a comprehensive examination. A urinalysis lab and CT of the abdomen is ordered. The results of the CT show two small kidney stones. The ED physician discusses the results with the patient and tells him the stones are small and will pass on their own. Medical decision making (MDM) of moderate complexity is made with the patient being discharged, with a prescription of pain medication, and with a diagnosis of kidney stones. Select the E/M code and diagnosis code(s).
1. 99283, N20.0
2. 99284, N20.0
 

sujaya101

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Seems like it's fr exam purpose. If you look up ER visits in your CPT book and match it with the criteria like detail history, comprehensive exam etc, you will find the answer. Preparation for exam is different than real life EM coding. I would look up both these codes and see which one matches. In real life, you would have to determine if the history is detail or if the exam is comprehensive and then determine the level of service. For exam those are already given to you.
 
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E/M is Hard!!

Does anyone have tips for coding E/M services.
I don't know if I overthink things. Does everyone chart it all out when figuring out the levels of history, exam and MDM or do you do it more simply?
ANY advice would be so so helpful.
 
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The patient is a 35-year-old male who presents to the emergency department (ED) after several hours of low back pain, nausea, and chills. The ED physician takes a detailed history and performs a comprehensive examination. A urinalysis lab and CT of the abdomen is ordered. The results of the CT show two small kidney stones. The ED physician discusses the results with the patient and tells him the stones are small and will pass on their own. Medical decision making (MDM) of moderate complexity is made with the patient being discharged, with a prescription of pain medication, and with a diagnosis of kidney stones. Select the E/M code and diagnosis code(s).
1. 99283, N20.0
2. 99284, N20.0
You need to meet 3 of 3 criteria when leveling an ED visit. If any one of the components does not meet a particular level, then it's not valid. The CPT book explains this in detail at the beginning of the E/M section. You also need to watch your diagnoses. N20.0 might not be the only code to use.
 
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