have two queations?
1.For all established visits does it NECESSARY that the ROS should be documented in each encounter OR it could be blank for level 99213-99214 and if not documented I just take the Elements from the Phy.Exam. and MDM and not the HISTORY for 2 OUT 3 if it meets the 2 components required (using the 1997 DG) to bill for 99213-99214?
The guidelines indicate that for established patients, you do not NEED one element over another to meet your level. If you are billing a 99213 and you do not have ROS, you should have documentation in the other areas (exam, decision-making). Without ANY ROS and using history to meet your level, the highest you are able to bill is a 99212.
2.What if I have only 2 status or inactive chronic illnesses in the HPI (1997 DG) can it qualifies for 99214? I would then use the HPI elements or the 1995 guidelines.
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join