tci Medicare Compliance & Reimbursement - 2007 Issue 32

REIMBURSEMENT: One Tell-Tale Sign That A Follow-Up Visit May Be A Level Four

Don't shortchange yourself for 'routine' visits.Myth: If an established patient comes back for a "routine" visit, you should automatically code that as a level-three evaluation and management (E/M) visit. Reality: You should always code based on what your physician actually documented and performed. There's no rule that says a routine follow-up must be a level three, notes Peter Jensen, a physician and founder of EMUniversity.com. Many physicians and coders wrongly believe that a "routine" visit should always fall smack dab in the middle of the bell curve, Jensen complains. "Most doctors don't give it a second thought...

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