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.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