AAPC - Back to school
Results 1 to 3 of 3

Thread: Need help with very short chart note

  1. #1
    Join Date
    Apr 2007
    Everett, WA

    Default Need help with very short chart note

    AAPC: Back to School
    Dr. is a specialist in migraines. Established patient. DX= 346.10. Chart notes follow:

    Pt presents for adjustment of stimulator settings. Pt. suffers from ongoing daily headaches. I recommended expanding the pulse width 3 days most distal contact point. Patient noted improvement in stimulation toleration and plans to have continuous stimulation

    That's it! It was submitted as a 99214, but obviously, that is incorrect. Shouldn't there also be a code from V53.XX as well? I'm just stumped on this one. Isn't this basically a problem focused exam and at best only be assigned 99213? No exam. MDM has stalled me. Would this be an established problem, worsening, or "stable" at this point? For "presenting problem" I have "moderate", and Management Options ????

    Can someone turn on a light for me, please? Perhaps it should be sent back asking for additional information?

    Suzanne E. Byrum CPC

  2. #2

    Default Migraine

    Looks like a V53.01 to me and 99214 looks ok for established patient...

  3. #3
    Join Date
    Apr 2007
    Evansville Indiana

    Default 99212

    I can't get more than a 99212 on this. It actually states notes improvement.

Similar Threads

  1. interpretation requested for short infusion note
    By ollielooya in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 10-10-2011, 09:51 AM
  2. Please help with short op-note
    By coders_rock! in forum Orthopaedics
    Replies: 1
    Last Post: 08-18-2011, 07:47 AM
  3. Please help with short op-note!
    By coders_rock! in forum Orthopaedics
    Replies: 1
    Last Post: 08-17-2011, 02:46 PM
  4. Help coding a short op-note
    By coders_rock! in forum Orthopaedics
    Replies: 2
    Last Post: 08-17-2011, 02:45 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.