tci Medicare Compliance & Reimbursement - 2007 Issue 29

PHYSICIANS: You Can Still Bill A Level-4 E/M Visit For A Patient With Abnormal Test Results

How to make your E/M documentation bulletproof -- even with few symptoms.Myth: You can't bill an evaluation & management (E/M) claim unless the patient has pain or some similar complaint. Reality: Sometimes it's test results that prompt a patient visit, not pain or even a complaint. A patient may come to a specialist or emergency physician because he has abnormal test results, says Kenneth Sable, a physician and director of the Division of Medical Informatics in the Emergency Medicine Dept. at Maimonides Medical Center in Brooklyn. Challenge: It can be a challenge to obtain four out of eight...

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