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Wiki Wound care and E & M levels

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carol52

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Question on E & M levels. Pt seen in wound care for continues problems , same DX by different Dr's. Some Doc's want to charge a 99214 for same problems billed by another Dr who previously charged a 99212. How do I approach this problem ?
 
review the notes and see if it meets the criteria, remember that medical necessity is the overarching criteria, even if on the surface the level meets a 4 the question is SHOULD it meet a level 4, are there parts documented that are unnecessary given the presenting issue?
 
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