Wiki follow 99233 for cancer history patient

[avhadvidya@gmail.com]

Hello Guys,

i have a big confusion in 99233 level when patient is with personal cancer history ,do we need to consider it as a high risk and need to give 99233 directly?
please help.

 

[thomas7331]

Absolutely not. Personal cancer history, by itself and out of context, does not automatically equate to any particular level of risk or CPT code. In any case, code levels for subsequent inpatient E&M services are assigned not based on level of risk, but based the CPT description which requires two out of three elements of history, exam and MDM meeting the required levels for the code, or based on time if appropriately documented. Risk is only one of many factors that is used to determine an E&M code.