Self limited problems

natraj21

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Hi,

What is the criteria to consider a condition as self limited?

An establised patient came with cough and sorethroat, physician has given the Dx as pharyngitis and has given OTC meds in outpatient clinic. which level can we give for this visit, there is sufficiant documentation of History and PE for EPF?
Please guide me through this.

THanks in advance

Natarajan Chellamuthu, CPC.
 

hewitt

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The attached Table of Risk, on page 37 of the document, should help a bit. In general, it is thought to be a problem that is limited to one system or body area and is self contained. It does not affect any other system or body area, and is easily managed. The problem, given time, might even resolve on its own. That's why on the Table of Risk examples of presenting problems are colds, insect bites, etc. For some these can become complicated, but for the most part are not. Managing these can simply be keeping the area clean, protected by a bandage or superficial dressing, etc.
https://www.cms.gov/Outreach-and-Ed...downloads//eval_mgmt_serv_guide-ICN006764.pdf
 
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natraj21

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The attached Table of Risk, on page 37 of the document, should help a bit. In general, it is thought to be a problem that is limited to one system or body area and is self contained. It does not affect any other system or body area, and is easily managed. The problem, given time, might even resolve on its own. That's why on the Table of Risk examples of presenting problems are colds, insect bites, etc. For some these can become complicated, but for the most part are not. Managing these can simply be keeping the area clean, protected by a bandage or superficial dressing, etc.
https://www.cms.gov/Outreach-and-Ed...downloads//eval_mgmt_serv_guide-ICN006764.pdf

Hi,
Thank you for your kind reply, the link you posted is useful for me. It helps me out.

Thanks

Natarajan Chellamuthu, CPC.
 

hewitt

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The use of an E/M coding tool will help you figure out what level E/M to code the detail. Do you have one? If you do not, please let me know, and I will send an example to you. Once you have the tool, all you need do is plug in the corresponding detail that applies to come up with an associated E/M.
 
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