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E/M 1997 Guidelines

  1. Default E/M 1997 Guidelines
    Medical Coding Books
    I needs some input please. I recently found some information for the 1997 E/M guidelines for the Exam part for Musculoskeletal System and what is required for each level of coding. 1, 3 vital signs, 2. general appearance 3, Cardiovascular periph,vasc.by obs & palp 4. Lymphatic Palp, lymph, nodes, any loc. 5. gait and so on. then you count up the elements for the levels. My question is. One of the physicians in our office refuses to do the Lymphatic due to he/she is saying it is a liability. but still want to charge a level 99204 for new patient. This would not cover all 30 elements. Is this right and is it really a liability. Personally never heard or read that. Confused. Help please... Thank you.

  2. #2
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    Baton Rouge
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    Quote Originally Posted by ajhunsicker View Post
    I needs some input please. I recently found some information for the 1997 E/M guidelines for the Exam part for Musculoskeletal System and what is required for each level of coding. 1, 3 vital signs, 2. general appearance 3, Cardiovascular periph,vasc.by obs & palp 4. Lymphatic Palp, lymph, nodes, any loc. 5. gait and so on. then you count up the elements for the levels. My question is. One of the physicians in our office refuses to do the Lymphatic due to he/she is saying it is a liability. but still want to charge a level 99204 for new patient. This would not cover all 30 elements. Is this right and is it really a liability. Personally never heard or read that. Confused. Help please... Thank you.
    This is just a guess on the liability issue based on something I've heard from a couple of providers, but I believe if they discover a problem during the exam, they're obligated to either treat it or refer the patient for treatment. BUT the same could be said for any cardio problems they discover...are they doing that part of the exam?...just a thought...

    Either way, if they aren't performing the full Musculo exam, they cannot bill a bill 4 new patient visit. I checked how the remaining exam would cover the Organ systems of the 1995 DG, and that doesn't appear to give a higher level either. Sooo (s)he will either have to do the full exam, or bill lower levels!!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  3. Default
    Thank you Thank you.... That helps a lot. One of our physicians needs everything in black and white.

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