tci E/M Coding Alert - 2013 Issue 3

Specialty Focus -- Pediatrics: Avoid Selecting E/M Levels Based on Diagnosis Cues

Here’s why you can’t assume a diagnosis always equates to a 99212, 99213, or 99214. While procedures and services such as vaccinations and nebulizer treatments have standard codes that you can learn and even memorize, E/M coding isn’t quite so straightforward. Consider this question submitted to E/M Coding Alert from a subscriber: “Which code should we report for evaluation of a cough, runny nose, and fever? We can’t decide whether it should be 99212 or 99213 — but the pediatrician actually marked 99214.” This question supports a common myth — that each type...

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