tci General Surgery Coding Alert - 2014 Issue 1

Reader Question: Don't Pigeon Hole E/M Services

Question: We recently finished our first internal audit and found a potential issue: One of the surgeons told me that he only chose level 99212 when it is a follow-up from a previous visit. He always chooses levels 99213 and above for everything else. Is that correct? Washington Subscriber Answer: No, that is not correct. Not just a follow-up problem-oriented visit for an established patient warrants a “low-level” code such as 99211 or 99212. And all other visits don’t automatically earn a higher E/M level. Your coding should never hinge solely on whether a problem is new...

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