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High level E/M?

  1. #1
    Location
    White Plains, NY
    Posts
    123
    Default High level E/M?
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    Established patient with four problems - all of them follow-ups. Progress notes a short assesment of each one, and a treatment plan. One is a toe nail Bx, one gets an injection, the other two are treated topically.
    Doc says that because there are so many, he should get a 99215. I've got no real HPI or ROS; one exam: skin. Not much detail.

    How should I code the E/M here?

    Thanks in advance

    Lin
    CPC

  2. #2
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Quote Originally Posted by losborn View Post
    Established patient with four problems - all of them follow-ups. Progress notes a short assesment of each one, and a treatment plan. One is a toe nail Bx, one gets an injection, the other two are treated topically.
    Doc says that because there are so many, he should get a 99215. I've got no real HPI or ROS; one exam: skin. Not much detail.

    How should I code the E/M here?

    Thanks in advance

    Lin
    CPC
    Could you possibly post the de-identified note? Without knowing how thorough of an exam, it's hard to come up with a level. Also, the number of diagnoses does not automatically make any E/M a level 5 - how much data was reviewed, and what was the risk? Thanks,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. #3
    Default
    CPT says "High Severity" for a 99215 Meaning some kind of life or death situation but you have to have alot of HPI and Exam for it to qualify. Not only that the MDM had to be some kind of Heart attack or some kind of Stroke during the visit and being sent to the ER for a "High Severity" condition. Just my opinion on this one

  4. #4
    Default
    i would maybe use a 99213 since its 4 problems then u have a procedure(s) with the visit

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