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Thread: 99283 vs 99284

  1. #1

    Default 99283 vs 99284

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    Hi all,

    I am an ER coder. I would like get more insight into ER codes 99283 and 99284. Are the codes differentiated only based on the History and Exam levels? Or is there any criteria for selecting 99283 or 99284 based on MDM (though the MDM in both the code description is moderate complexity).

    To be more clear, can we consider 99283 as low moderate MDM and 99284 as high moderate MDM. Does such concept exist?

    Your valuable inputs are much appreciated.

    Happy coding,
    Viji

  2. #2
    Join Date
    Apr 2007
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    Default

    The definition in CPT for 99284 MDM states "Usually the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate threat to life or physiologic function." To me, that meets your description of "high moderate severity". Just my interpretation.
    Lisa Bledsoe, CPC, CPMA

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