tci E/M Coding Alert - 2022 Issue Q4

Reader Questions: Course-Correct With a Tricky Provider Conversation

Question: We have a provider in our practice that insists on adding an office/outpatient evaluation and management (E/M) code for every patient that already has an established plan of care. The provider states that the patient’s care plan changes at every encounter, even if they are coming in for care of an ulcer they have had for years, as the wounds are always changing. However, when I look at the documentation, I see nothing has changed since the last encounter, and no new problems are being addressed to justify the E/M. How do I communicate effectively to the...

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