tci ED Coding & Reimbursement Alert - 2003 Issue 10

Reader Question: Count Acuity Caveat for HPI

Question: Can the acuity caveat apply to the patient's history of present illness (HPI)? We had a patient come in with severe dementia, and the physician was unable to obtain the review of systems due to the dementia.      Missouri Subscriber Answer: According to the description of code 99285 (Emergency department visit for the evaluation and management of a patient, which requires these three key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: a comprehensive history, a comprehensive examination, and medical decision-making of high complexity), you...

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