tci Part B Insider - 2015 Issue 4

Part B Coding Coach: Avoid Losing $35 Per Visit By Correctly Choosing Between 99213 and 99214

Knowing what to look for in documentation is the key to deciding outpatient visit leveling. Are you a chronic E/M downcoder? Physicians tend to report 99213 for a larger percent of their office visits than they do 99214, when in fact reporting 99214 may be more accurate if you have supporting documentation. But because 99213 pays about $73 compared to $108 for 99214, you could be forfeiting $35 every time you downcode your claims. Read on for tips that will help you confidently select between these two common office visit codes. Rely on the Descriptor and Examine the Note...

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