You will probably get many different opinions about this but here is mine.
I see many situations in which a preventive is done along with a 99214.
Think about it. What does it take to hit a 99214? It is 2 of 3 and since you are doing a preventive service you can pretty much forget about getting credit for exam, how can you separate it out? So you are looking at history and mdm. You need a cc (earache), 4 HPI elements (left ear, 3 days, can't lay on that side, tylenol doesn't help) 2 ROS (runny nose but no fever), 1 PFSH (NKDA), and moderate mdm (OM -new problem 3 points, antibiotic- Rx management).
Does an ear infection stop you from doing a preventive visit? I wouldn't think so. Does it support a 4? It sure can if they document enough.
Just my opinion and how I look at it,
Laura, CPC, CPMA, CEMC
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