Wiki Practice test EM ?, what the heck am I missing!!!

[jbc616]

Ok, here is the question on the practice test:
63 yr old man wants a 2nd opinion for his sleep apnea. He decides to go to another Dr. Dr. documents a detailed history. He has had it for the past 5 months. Sleep is disrupted by frequent awakenings and getting worse due to anxiety and snoring. Current medication that he is on now is not helping him. Dr. also performs a comprehensive exam and moderate MDM. What CPT code should be reported?
A: 99204
B: 99203
C: 99243
D: 99214
Ok so I eliminate C&D. That leaves me with A&B, of which I choose A. I choose A because Dr. has taken a detailed history, comprehensive exam and moderate MDM. Apparently I'm wrong. It's B. Don't I "code up" on the history, because the exam was comprehensive and MDM was moderate which matches 99204. What am I missing. Any help would be greatly appreciated!! (I'm developing anxiety!)

 

[OCD_coder]

All three components, Hx, PE and MDM must meet or exceed the E&M level, in this scenario it would be the lowest of the 3 components.

You cannot "code up" because your history is too low to support a 99204, the highest you could bill with a detailed history is a......99203. Regardless, if you have a comprehensive exam and Moderate MDM.

 

[angelo_valencia]

It's 99283

I agree with OCD coder ^^

H= Detailed =3 (B: 99203
)
E=Comprehensive = 4
M= Moderate = 4


For a new patient, it requires 3 key components. The rule states, that if it's 3 out 3 you need to code the lowest. Go with B: 99203

 

[twizzle]

I agree with OCD coder ^^

H= Detailed =3 (99283)
E=Comprehensive = 4
M= Moderate = 4


For a new patient, it requires 3 key components. The rule states, that if it's 3 out 3 you need to code the lowest. Go with 99283

99203 (not 99283..not sure where that came from). History is driving down the level of everything else.