tci E/M Coding Alert - 2016 Issue 9

Reader Question: Use These Details to Decide Patient Status

Question: An intensive care physician asked my pediatrician to see a premature newborn who was having respiratory problems in the hospital. The pediatrician subsequently saw the infant three weeks later in the office for an initial office visit. The pediatrician documented a detailed history, a detailed examination, and low-complexity medical decision-making during the office visit. Should I report 99203? Louisiana Subscriber Answer: That would be the correct code if the infant were a new patient, but in this case, you treated an established patient. Why? Once your physician has provided a face-to-face service for the patient, the child...

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