tci General Surgery Coding Alert - 2006 Issue 8

Coding Basics: 'New' or 'Established' Might Matter More Than You Think

2 questions allow you to pick the right code -- and right level -- every time When reporting many common E/M services, you must know two things: 1. Is the patient new or established? 2. What are the documented levels of history, physical exam, and medical decision-making (MDM)? Here are quick instructions on how to use this information to select the correct E/M level every time. -3-Year Rule- Determines Patient Status Generally, you should consider a patient to be -established- if any physician in your group (or, more precisely, any physician of the same specialty billing under the...

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