tci E/M Coding Alert - 2017 Issue 3

Reader Question: Discern Requirements for Preventive Care/Problem-Focused E/Ms

Question: Our providers perform many preventive care services like physicals and wellness exams, and for about half of these, they want to charge for a problem-focused visit as well. What are the criteria for meeting the documentation requirements of billing a preventive care service with a problem-focused visit? Rhode Island Subscriber Answer: You may be able to report a problem-oriented E/M in addition to a scheduled preventive care visit when a patient comes in for a visit such as an annual exam, Pap test, or screening mammogram and mentions a specific healthcare problem or other concern. According to CPT®...

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