tci Medicare Compliance & Reimbursement - 2006 Issue 43

E/M CODING ~ Look For More Detailed Statements, Extra Elements When Reporting Code 99214

Beware of vague guidance from CMS regarding this code. You can't rely on the number of organ systems or body areas to figure out if your evaluation & management (E/M) visits with established patients meet the requirements for a 99214. But don't panic: You can bill the 99214s you deserve, if you pay attention to your doctor's documentation and the guidelines from the Centers for Medicare & Medicaid Services (CMS).What CMS says: The actual written guidance from CMS is "extremely vague," says Catherine Brink, president of HealthCare Resource Management in Spring Lake, NJ. CMS will never publish...

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