Results 1 to 2 of 2

Prophylactic Measure

  1. #1
    Overland Park, KS
    Default Prophylactic Measure
    Medical Coding Books
    A new patient comes into the clinic for a travel exam because they are going overseas. The CC states the following:

    Need for malaria prophylaxis; will be traveling to Mexico/bordering Belize

    Is this a valid CC to constitute a new patient visit? The HPI has when the patient is leaving and when they will be returning. It also states that the patient denies any renal disease, liver disease and pregnancy. I don't see this as associated signs and symptoms because there is no complaint to tie this to. An exam was performed and the patient was given a prescription for a malaria prophylatic pill.

    The provider coded this as a 99202. I say that without a valid CC or HPI, the history level is not there and the key components are not met.

    Can we report an unlisted E/M for this? No counseling is documented so 99401 is not an option.

    Any advice is appreciated.

    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  2. Default
    99201 or 99202 sounds reasonable to me. It's definetly a low level service, sounds like he did do some exam work. It doesn't really fit with 99401 I agree.

Similar Threads

  1. MR for implant measure
    By PLAIDMAN in forum Interventional Radiology
    Replies: 0
    Last Post: 02-04-2013, 10:38 AM
  2. PQRS Measure 76
    By bkeeling in forum Anesthesia
    Replies: 5
    Last Post: 04-13-2012, 07:31 AM
  3. How to measure total sq cm
    By MsAnna in forum Dermatology
    Replies: 2
    Last Post: 02-27-2012, 02:39 PM
  4. PQRI Measure #43
    By OliviaPrice in forum Medicare Regulations
    Replies: 6
    Last Post: 09-16-2009, 12:25 PM
  5. Billing For Measure
    By sblanchard in forum Anesthesia
    Replies: 2
    Last Post: 11-06-2008, 10:21 AM

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.