tci E/M Coding Alert - 2022 Issue Q4

Reader Question: Append These Modifiers for Bone Cyst Evaluation

Question: A new patient reports to the orthopedist complaining of left shoulder pain. The provider performs an evaluation and management (E/M) service that lasts 43 minutes and involves low-level medical decision making (MDM). Based on the E/M, the orthopedist orders a computed tomography (CT) on the patient’s shoulder with contrast. The CT was performed and interpreted at another facility. Final diagnosis was solitary bone cyst, left shoulder. How should I report this encounter? Illinois Subscriber Answer: On the claim, you’ll report: 99203 (Office or other outpatient visit for the evaluation and management of a new patient, which...

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