HELP WITH 2021 E/M CRITERIA FOR PROCEDURE CODES 99204 & 99214

haraml7

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HI,
So a "unique test", in my opinion, would be a test (in other words) that could be and/or have been billable at some point. So like your labs, radiology, or your codes from the medicine section. I am not saying that the provider has billed for it, or is billing for it at the moment of the encounter, but I see it as something that would or could be billable. So for Body composition/Body fat analysis, is this considered just the BMI the provider is reviewing, or is the patient wanting bariatric surgery and obesity counseling has been inherited into this office visit.
There is a great article that NAMAS posted that may help with your question too. Its about the gray areas of E/M.

Don't hesitate to reach out if you have any other questions.
Thanks :)
 
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Thank you so much for that link!
This is for health and wellness, no bariatric surgery.
So basically in our EMR system there is our laboratory/diagnostic section where we have our services (labs, ekg, etc) Body composition is also a service choice, but we generally don't bill separately for this. The BMI diagnosis code is automatically billed with the procedure and diagnosis codes, just wasnt sure if that qualifies as a 'unique test'...But reading that info, I think I found my answer!! Thank you so much!
 
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