Results 1 to 4 of 4

E&M Level of Care

  1. #1
    Default E&M Level of Care
    Medical Coding Books
    We have a new patient with a "Detailed History", "Expanded Problem Focused", and "High Medical Decision Making".
    Would you code it as the lowest level (EPF) of 99202?
    Per AAPC CPC Study Guide, two of three key components are needed to make established patient level visit. I am unable to find information for 1995 or 1997 guidlines showing how to code NP & Established patient when there are three different key components.

  2. #2
    Columbia, MO
    For new patient you must meet or exceed all three key components. So in other words the lowest of your three components will determine the level even though the other two exceed the requirement for that level. So yes in your example you would got to the 99202.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Biloxi, MS
    Yes, your example depicts a 99202 level of service based on the EPF exam.
    Kimberly L. Crear, CPC, CEMC

  4. Default Agreed
    I agree, But I would question whether this is a documentation issue. High MDM and Detailed History don't always fit with an EPF PE. If you are concerned provider isn't documenting all PE elements that were done, you might want to review with provider.

    Jim S.

Similar Threads

  1. Replies: 0
    Last Post: 08-07-2015, 12:40 PM
  2. Choosing the Level of Care
    By in forum E/M
    Replies: 1
    Last Post: 07-31-2014, 08:46 PM
  3. H&P performed with level 3 visit, raise level 4?
    By LynnS.321 in forum Orthopaedics
    Replies: 1
    Last Post: 10-23-2009, 06:28 AM
  4. ER E/M level of care charges
    By tuffy1 in forum E/M
    Replies: 2
    Last Post: 03-11-2009, 06:18 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.