tci E/M Coding Alert - 2016 Issue 2

Reader Question: Base Coding on HEM, Not Visit Type

Question: I have a provider that saw a patient on Monday and coded a 99214. He then saw the same patient the next day for a follow up and coded a 99213 and 10060. Is this correct coding or should the E/M for the follow-up visit be a 99212? New Mexico Subscriber Answer: Code 99212 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making …) or 99213 (…which requires at...

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