Check 2008 CPT Professional Edition, begining on page 3 under "Nature of Presenting Problem."
I would characterize pharyngitis as "self-limited or minor"
Now go to page 5-6 under "Instructions for Selecting a Level of E/M Service" and you'll note on page 6 under "Review the Level of E/M Service Descriptors and Examples in the Selected Category or Subcategory," the last paragraph in this section reads:
"The nature of the presenting problem and time are provided in some levels to assist the physician in determining the appropriate level of E/M service."
Now go to page 10 and find the descriptions of Established Patient Office Visits ...
Under 99212 it states: "Usually the presenting problem(s) are self limited or minor."
Under 99214 it states: "Usually, the presenting problems(S) are of moderate to high severity."
This is why you might be told that Pharyngitis is a "weak diagnosis" for a level 4 visit, even when the documentation meets all the bullet points for that level.
F Tessa Bartels, CPC, CPC-E/M
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