tci ED Coding & Reimbursement Alert - 2006 Issue 1

Reader Questions: Look at MDM for 99282-99283 Split

Question: We regularly see these two diagnoses:- dental pain, abscess, no tests, discharged with antibiotic and Percocet- otitis media, no tests, discharged with antibiotic.Supposing we have all the necessary documentation for the highest appropriate E/M level, should I report a level two or a level three? Would you explain why?Oregon Subscriber Answer: For these typical presentations, 99283 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: an expanded problem-focused history, an expanded problem-focused examination, and medical decision-making of moderate complexity) will usually represent the correct code choice, assuming adequate...

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