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Thread: Level 99214 for bilateral knee?

  1. #1

    Question Level 99214 for bilateral knee?

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    If the documentation meets the guidelines for level 99213, for each knee seperately, do we get a higher level for addressing both knees? Thank you, mary mmadrigal@hawaii.rr.com

  2. #2

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    For E/M you would not get a higher level for two knees because both are part of the MS system. You would only get reimbursed at a higher level for both knees by adding a modifier 50 to a surgical procedure. I do not see how documentation would support it based on the fact that both knees were exam when they are part of one body system.

    Simone Williams, CPC

  3. #3
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    in the 97 guidelines under musculosceletal body system each extremity couts separately for bullets if you have enough exam to add up and the history and or decision making is enough to equal a 99214 then you have it. But just because 2 knees were looked at is not enough, just because exam is detailed is not enough to be a 99214 if the neither of the other 2 key components cannot rise to the occasion.

    Debra A. Mitchell, MSPH, CPC-H

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