tci General Surgery Coding Alert - 2009 Issue 3

You Be the Coder: What Warrants a Level-Four Consultation?

Question: I have a question regarding E/M coding for our office, a general surgery practice. Our physicians are coding a higher E/M code for a patient with, for example, gallstones when the patient has other factoring problems such as diabetes, COPD, hyper-tension, etc. Normally I would code a 99243 for gallstones, but if the patient has other problems as stated above, the physicians want me to code a 99244.  Some insurances have requested office notes for these patients, have reviewed the notes, and are asking us to downcode to 99243. We have been under the impression that we...

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