AAPC - Back to school
Results 1 to 3 of 3

Thread: 99215 ???

  1. #1
    Join Date
    Apr 2007

    Default 99215 ???

    AAPC: Back to School
    I am reviewing some E/M coding and am stumped about these 2. Thoughts please.

    First case - 18 month old comes in one day and diagnosis is epistaxis and impetigo. Bactroban prescription is given. Returns very next day for WCC and cellulitis Lt thigh & Rt knee. A WCC is done with the following information:
    Nutritional history done
    Current meds - claritin
    NCSLV (no change since last visit - day before)
    Physical assessment: height, weight, head circ, chest circ, temperature, pulse, respirations
    Notations under exam: cellulitis lt thigh, r knee
    HBG 12/1
    Oral lead risk is negative
    Plan - 1 gm rocephin

    Physician wants this coded as a 99215

    Second case - 11 year old comes in for weight check and vomiting 4x's
    Notations read:
    Current meds - stool softeners
    Illness/Accident/ER/Hospitalization - none
    NCSLV 1 month ago
    CC: Loves to eat
    vomiting - how long - last night 4 times, no f/d
    weight/ pulse/ respirations taken
    parent states: sneaking soda/ sweet tea
    Expanded exam is done
    Dx = Morbid obesity, allergic rhinitis ETD
    35 minute counseling
    claritin otc


  2. #2


    In the first one, are you asking about the well child visit or the first visit? If well child, you would use well E&M 99392, and the cellulitis could be considered part of the well visit. If the provider documented enough to support the well visit and wants to charge a sick ov code as well, use a modifier and charge both.
    If you were referring to just the first sick visit, there is no way the nature of presenting problem would support a 99215. (even if there is enough documentation in the chart not.)

    The second one, it looks like provider is documenting time. With 35 minutes face to face, that would only be a 99214.

    Hope this helps!

  3. #3
    Join Date
    Apr 2007


    Thank you for the help.
    In the first scenario, I am referring to the 2nd well care visit. I'm not sure there is enough documentation to support both the wcc and the ov. I'm leaning towards the wcc.

Similar Threads

  1. is this 99215
    By perkins05 in forum E/M
    Replies: 6
    Last Post: 02-13-2012, 12:24 PM
  2. 99215?
    By lynnmc79 in forum E/M
    Replies: 1
    Last Post: 09-28-2010, 09:39 AM
  3. 99215
    By puggles in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 07-22-2010, 07:46 AM
  4. 99215???
    By HBULLOCK in forum E/M
    Replies: 1
    Last Post: 07-15-2010, 08:25 AM
  5. Sent to ER...99215?
    By chetubig001 in forum Auditing General Discussion
    Replies: 2
    Last Post: 03-16-2010, 10:04 AM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.