• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki E/M for Med refill scenarios

lhoot

Guest
Messages
86
Location
Eldersburg, MD
Best answers
0
Good Morning,
Need some help untangling the logic for visits for medication refills in different visit settings.
Pt is seen for asthma med refill. No exacerbation or issues are noted. Comprehensive History and Comprehensive Exam is done.
According to the established matrices for code selection, I'm arriving at the following codes:
If this visit is a new pt in an office visit setting the code is 99204.
If this visit is in an ED, the components qualify for either a 99283 or a 99284. (Since the pt isn't experiencing any issues, I would tend to choose 99283.)
If this is an established pt in an office visit setting, the components qualify for a 99214. (However, since the patient is an established patient, the comprehensive history and exam may be overdocumentation and I would feel more comfortable with a 99213.)

In an ED or new pt office visit setting, the physician has not seen the patient before, so the comprehensive exam and history are reasonable expectations. A prescription is given, so there is medication management for a moderate risk level. Are there any other considerations, guidelines or official direction that would require this visit scenario to be a level two in any of these circumstances? I understand that many facilities and practices put policies of their own in place to fill in the grey areas of E/M coding and I'm interested in what the industry standard is; however, I'm more interested in any official guidance for this.

Laura
 
Top