Office Vists
Your doctor documents signs and symptoms and a definitive diagnosis. What do we code?
Definitive Diagnosis
During Hospital Roundings, the doctor sees the patient for an initial visit. What is the CPT code if it is a moderate level?
99222
In the ER, are there one set of codes? Or are there two sets of codes for New and Established patient?
One set of codes. 99281-99285
Patient is seen in his PCP's office for the first time.
MDM low
45 minutes in the visit documented
99204
MD and APP act as a team. APP sees the patient and the doctor follows up with the patient during the same visit. Both sign the chart. MD must do the significant portion of the visit to get credit.
99202 - 99205 represent which type of E/M?
New Patient Visits (office)
What is the code set for hospital inpatient subsequent visit?
99231-99233
Critical care codes 99291-99292 are based on time and has a list of what's included in your book. Is intubation considered a part of critical care time?
No. Code intubation by itself and do not include that time in the total time for CC
Established patient at her PCP's office has a visit where MDM is High. TIme in the visit was 30 min. What is the code?
99215
What is Incident To and where does it happen?
Incident to is Office based. The MD must see the patient on their initial visit to create a plan. After that, an APP can see the patient and follow the treatment plan the MD set up. Incident to means the APP is seeing the patient on the MD's behalf and MD will get paid because it's his plan. If the APP does anything off that plan, she can bill under her name.
What code set represents Established Office Visits?
99211 - 99215
There are two IP discharge codes. If the patient discharge takes less than 30 minutes, what is the CPT code we use?
99238
Patient is seen in the ER getting Critical Care. The doctor provides services for 28 minutes before sending the patient to surgery. What would we code?
99285. CC is 30-74 minutes to code 99291
Telemed visit that is 20 minutes long with a moderate MDM level
98006
If a Hospitalist sees a patient and someone from another specialty office sees that patient on the same day, can they both bill?
Yes. Because they are two separate offices, they can each drop an E/M. If they belong to the same office or physician group, only one can bill.
A patient who was seen in the office 3.5 years ago comes in for a level three office visit. Do we code 99213 or 99203?
99203. Patient is considered a new patient because they haven't been seen by that office within the past three years.
Inpatient consults are what code set?
99252-99255
Patient is seen in the ER and gets Critical Care for 110 minutes. What would you code.
99291 30-74 min
99292 75-105
99292 106-110
Inpatient hospital patient is seen for the first time by your doctor. She spends 80 minutes evaluating and treating the patient with a high MDM.
99223
Where can you find your levels of medical decision making?
In the front of the E/M chapter.
99242-99245 is the code set for.....?
Office or other outpatient setting consults
What three things must a consult contain?
1. Request from another provider
2. Consult must share their medical opinion
3. Consulting provider needs to respond with a written report to the requesting provider.
Patient seen in the ER.
Low MDM
What would be your code?
99283
Your doctor is rounding in the hospital on a patient he saw yesterday. He spend spends 30 minutes with the patient and MDM is high.
99233
What is a stable, acute illness?
A problem that is new or recent for which treatment is initiated. Pt has improved and, while resolution may not be complete, is stable with respect to this condition.