tci E/M Coding Alert - 2015 Issue 3

Reader Question: Link an FBR to an E/M

Question: A mother brings her child into the office complaining that the child’s breath is bad. Our physician examines the pharynx to find a stuck fish bone. The physician removes the bone with tongs. How do I code this? Massachusetts Subscriber Answer: If documentation supports billing separately, you will code the E/M visit from the 99211-99215 (Office or other outpatient visit for the evaluation and management of an established patient ...) range and report 42809 (Removal of foreign body from pharynx) for the foreign body removal (FBR). Your provider would need to document the decision for the office...

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