Asthma Attack Coding: When To Use Prolonged or High-Level E/M
Posted on 01. May, 2009 by Editor in Hot Coding Topics
Checklist deters payback requests for insufficient +99354 time.
After spending almost an hour stabilizing an acute asthmatic, an extra $60 can be in store provided you make the right choice between coding prolonged services or a higher-level E/M.
Case study: A patient requires two nebulizer treatments and lengthy treatment time due to hay fever with exacerbated asthma (493.02, … extrinsic asthma; with [acute] exacerbation). Which of the following E/M options, would you report?
a. 99214 — Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; a detailed examination; medical decision making of moderate complexity … Usually, the presenting problems are of moderate to high severity. Physicians typically spend 25 minutes face-to-face with the patient and/or family.
and +99354 — Prolonged physician service in the office or other outpatient setting requires direct [face-to-face] patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management service)
b. 99215 — Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; a comprehensive examination; medical decision making of high complexity … Usually, the presenting problems are of moderate to high severity. Physicians typically spend 40 minutes face-to-face with the patient and/or family.
Check Typical 493.02 HEM
This encounter will most likely qualify for a level-four established...
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