e/m coding(preventive code)

caniford

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I work for doctors who mark preventive code and then give me diagnosis (ex:eek:steoporosis) so to be able to use the e/m code also what level is generally considered normal? I haven't went to the physicians yet (just took over the billing) because I want to make sure I have correct info. I have read the cpt guidelines but not quite sure how it all goes together?

christina cpc-a
 
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Hi,

Preventive codes are based on age group so I'm not sure what you mean by "what level is normal". Do you mean for selecting an E/M code? If so, you have to audit the chart note to be able to select the correct level of service, i.e. does the service meet or exceed each of the three key components.

Also, I'm wondering if the physicians are indicating to you that they want both a Preventive visit and an E/M visit for the DOS. As you may already know, this is allowed when all criteria are met for both services and by appending modifier -25 to the E/M code.

I think your instinct about going to them directly to find out what they are marking is right on the money. Maybe the don't know to use V codes for Preventive visits?

Good Luck!
 
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