tci E/M Coding Alert - 2019 Issue 1

You Be the Coder: Know How E/M Rules Differ in ED Setting

Question: Our PM specialist was called to the ED to see an established patient for an E/M service. Notes indicate that the provider performed a detailed history, a detailed exam, and moderate-complexity medical decision making (MDM). I’ve never used ED E/Ms before, so can you help me choose the correct one for this patient? New Mexico Subscriber Answer: On your claim, you should report 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity …) for...

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