Medicare tells us that the overarching criteria for all documentation is medical necessity. Is it medically necessary to have a comprehensive history and exam for otitis media? Probably not.
Therefore, you should more appropriately code 99283 for these visits.
This is a nebulous criterion, however. And it is a matter of judgment. I personally would code 99283, but if the documentation supports 99284 I wouldn't be able to state that the coder is wrong.
Clear as mud, I know ...
F Tessa Bartels, CPC, CEMC
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join