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Thread: E/M level for special situation

  1. #1
    Join Date
    Apr 2007

    Red face E/M level for special situation

    AAPC: Back to School
    Need some help! Have a doc who sees patients for pessary issues. A good portion are usually the same thing...patient comes in for a pessary check. The CC is usually that the person is there for a pessary check. There isn't much on ROS (if any mention at all). Then for the PE...what he is doing doesn't really fall under the guidelines. He usually removes the pessary, performs chemical cautery (for vaginal ulcers), and reinserts the pessary. Not much of what he does falls neatly under the guidelines... He said he thought that he heard somewhere that a pessary check w/ chemical cautery is an automatic 99214; I haven't been able to substaniate his claim with any hard copy or anything online. Most of the charts like this that I have looked at only come out to a level 99213.

    Can anyone give me some help, insight, etc... greatly appreciated!! Thanks!

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    There is no automatic anything for E&M. you must meet the criteria for a given level per the 95/97 guidelines.

    Debra A. Mitchell, MSPH, CPC-H

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