tci ED Coding & Reimbursement Alert - 2010 Issue 2

READER QUESTIONS: Counseling Exception? Not in ED

Question: A patient with a chronic gastric ulcer reports to the ED complaining of nausea, vomiting, and headache. One of our nonphysician practitioners (NPPs) spends 34 minutes with the patient, and performs an expanded problem focused history and exam and moderatecomplexity medical decision making during the encounter. During the history portion of the E/M, the patient reveals that she has not been to a physician in "four or five years" for treatment of her ulcer. The note indicates that the NPP spent 21 minutes advising the patient on proper diet and medication management, and encouraging the patient to resume...

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