tci E/M Coding Alert - 2017 Issue 7

Reader Question: Medical Necessity Key to Reporting 99212

Question: A patient came in for a flu shot. Can I report an office visit code (such as 99212) or should I just report 90658 and 90471? Pennsylvania Subscriber Answer: No. Based upon the given information, simply administering an injection, such as a flu shot, does not warrant reporting an evaluation and management (E/M) code like 99212 (Office or other outpatient visitfor the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making …) In your case, you...

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