Results 1 to 4 of 4

Please Help!!!! Very Confused

  1. #1
    East Stroudsburg
    Default Please Help!!!! Very Confused
    New Call-to-action
    Hi, I could really use some help with this.

    If I have an EPF history, a comprehensive exam and a moderate MDM for an established patient wouldn't I choose a 99213? Since I don't have 2 out of 3 components wouldn't I choose the one farthest to the left or would I choose the 2nd from the left?

    Please help ASAP, I am really confused about this. I always thought it was the one farthest to the left.

    Thank you,

  2. #2
    Columbia, MO
    If it is an established patient then you may eliminate the lowest component and use the other two components for the level, in this case the history is the lowest so it may be dropped from consideration. You are left with comprehensive exam, and moderate MDM so the lowest of these two will determine the visit level. Moderate MDM equates to a 99214 without exceeding your level of comprehensive exam. I have never heard the method of "farthest from the left" so I have no idea what you are referring to with that.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Everett, WA
    I'm not sure what you mean by "farthest from the left". And I think your confusion may originate from thinking that two out of the three must be identical, i.e. being both "moderate" or "comprehensive?" This is not the case. Do as Debra advised and you can cross out one of the three components---in this case the expanded HPI. Now you have comprehensive exam and moderate MDM which = 2/3. Look in your CPT book for the established patient requirements and you'll see that comprehensive and moderate "meet" the "detailed" requirements" for 99214 (Level 4) but the MDM is lacking to assign to 99215 (Level 5). Therefore, 99214.---Suzanne E. Byrum, CPC

  4. #4
    East Stroudsburg
    Thank you both very much. I did think that two out of three must be identical and if not it would be the lowest level. I didn't realized you could drop the lowest one. Again, thank you so much.

Similar Threads

  1. Confused!
    By nonadianne in forum Diagnosis Coding
    Replies: 1
    Last Post: 07-11-2012, 09:04 AM
  2. Am I Confused?????? - they are coding
    By LewinFamily in forum Auditing General Discussion
    Replies: 1
    Last Post: 11-10-2010, 11:29 AM
  3. Am I Confused?????? - local anesthesia
    By LewinFamily in forum Anesthesia
    Replies: 3
    Last Post: 10-27-2010, 07:23 PM
  4. Am I Confused?????? - basic cystoscopies
    By LewinFamily in forum Billing/Reimbursement
    Replies: 1
    Last Post: 10-27-2010, 05:37 PM
  5. Am I Confused??????
    By LewinFamily in forum General Surgery
    Replies: 0
    Last Post: 10-27-2010, 12:24 PM

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.