Guest guest Posted January 19, 2009 Report Share Posted January 19, 2009 Chirag,The E/M code is not determined by the diagnosis. It comes down to how much you can document.This article from Family Practice Management can help you:http://www.aafp.org/fpm/20070100/21leve.html SetoSouth Pasadena, CACan somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2009 Report Share Posted January 19, 2009 Based on how much you did. I always charge it as a 99213, ROS (anyother related symptoms?), any meds taken for it? How often have you had this?(Past med hx), Fulll HEENT, lungs checked, skin checked for rashes, plan - 99213 it is. To: imp imp < >Sent: Monday, January 19, 2009 5:28:40 PMSubject: OTITIS MEDIA/URI Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2009 Report Share Posted January 20, 2009 I usually charge 99212 based on a recommendation from a coding specialist I hired for an hour years ago. Perhaps I am undercharging. I was told that the complexity of the visit is too low to justify 99213. And yes, I am aware that we need only 2/3 (history, exam, complexity) for an established patient to code. Alla Alla Kirsch, M.D.Travel Clinics of America6559 Mills Road, Suite 107, Mayfield Village, OH 44143 | cell | fax | www.travelclinicsofamerica.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2009 Report Share Posted January 20, 2009 I bet you are undercharging too. Especially since one of us IMP's showed how even strep thoat can be a level 4 legitamately. I've never had anyone downcode me for level 3 for otitis media or uri. Subject: Re: OTITIS MEDIA/URITo: Date: Monday, January 19, 2009, 7:11 PM I usually charge 99212 based on a recommendation from a coding specialist I hired for an hour years ago. Perhaps I am undercharging. I was told that the complexity of the visit is too low to justify 99213. And yes, I am aware that we need only 2/3 (history, exam, complexity) for an established patient to code. Alla Alla Kirsch, M.D.Travel Clinics of America6559 Mills Road, Suite 107, Mayfield Village, OH 44143 | cell | fax | www.travelclinicsof america.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2009 Report Share Posted January 20, 2009 I have had many reviews of my coding over the years, by the coding specialists of my former large employer, and they all agree that AOM (the way most of us would document it) is a 99213. ---Sharlene------ In , Chirag Patel wrote: > > Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2009 Report Share Posted January 20, 2009 I also always bill a 99213 for a viral URI. In the process of ruling out a bacterial infection, I ask plenty of questions and do plenty of exam to justify that level. And then, there's always the discussion about how antibiotics don't work for viral infections and the one about all the OTC stuff they can use or why not to use them in young children...It would actually be SIMPLER to dx. Strep throat and give an antibiotic!---Sharlene--- > > Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2009 Report Share Posted January 20, 2009 pardon me for intruding here, E/M coding depends on elements of work that you 'document'.see the note below is 99214*************************Pt with DM, HTN, Dyslipidemia comes for follow up on DMROS: No CP, No SOB Meds reviewed with ptA/P-1) DM- Increase Lantus from 200 to 201 unit2) HTN 129/79 controlled************************************************this example tells what a joke E/M coding is.from pt care point, this note is crap but in the eyes of E/M, it is worth 90 dollars on US Taxpayers. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2009 Report Share Posted January 20, 2009 1) I never bill for a 99212. That would be in my old office when a nurse was doing a brief visit with the patient and I glanced at the patient, agreed with the nurse's note and signed off.If a patient is " sick " and I need to " assess " them, it's starting at a 99213.2) For an AOM to be a 99214 there would usually have to be other issues involved, like fever/dehydration/cough/vomiting. If I am assessing those along with the AOM, the complexity increases too, and I will code for 2-4 problems, and then bill the 99214. And, actually, coming to the decision to give antibiotics by itself almost pulls an appointment to a 99214, so you don't need much more than that to make it a clearly appropriate. Consider the number of systems involved with the ROS -- consitutional, eyes, ears/nose/mouth/phar, chest, heart, GI, skin, musculoskel; and in the PE -- VS, General, eyes, ears/nose/mouth/throat,cardio, resp, gi, musculoskel, skin, lymph. That is coding out as a 99214 if I'm not mistaken, and I'm really not stretching.So, it all depends.3) BUT, let's all note, once again, just how stupid this whole game is with coding and billing. Just that we have to waste time and energy discussing this.What is helping the patient and patient's family is the access to the doc, good evaluation, clear explanation and no barriers to follow up in case things don't go as planned. That comfort patients can have is an important part of real health!Tim I usually charge 99212 based on a recommendation from a coding specialist I hired for an hour years ago. Perhaps I am undercharging. I was told that the complexity of the visit is too low to justify 99213. And yes, I am aware that we need only 2/3 (history, exam, complexity) for an established patient to code. Alla Alla Kirsch, M.D.Travel Clinics of America6559 Mills Road, Suite 107, Mayfield Village, OH 44143 | cell | fax | www.travelclinicsofamerica.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2009 Report Share Posted January 22, 2009 would someone please tell me how to have someone come in for just a URI? without some sort of emotional crisis, or poorly controlled bp, or issue pertaining to some other biopsychosocial drama? tac p.s. its sort of a rhetorical question, if you don't ask the dreaded " how are you? " i think they will just stick to thier snot, but then life would be boring. Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? -- Crowley, MD Family MedicineCape May Courthouse NJPatients, please allow up to 48 hours for response. If you are having an urgent problem please go to the emergency department or call 911. If you have a problem or question that can't wait 48 hours, or you have not received a timely response, just call the office at 465-0882. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2009 Report Share Posted January 22, 2009 Yeah, Don’t ask me. I was lamenting that to myself just last night. Could I please have a simple Htn recheck? Even the URI was also umbilical hernia and sore elbow. Something easy, I feel good, here are you meds. Good bye. That would be so great. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypractice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: [mailto: ] On Behalf Of Crowley Sent: Thursday, January 22, 2009 4:10 PM To: Subject: Re: OTITIS MEDIA/URI would someone please tell me how to have someone come in for just a URI? without some sort of emotional crisis, or poorly controlled bp, or issue pertaining to some other biopsychosocial drama? tac p.s. its sort of a rhetorical question, if you don't ask the dreaded " how are you? " i think they will just stick to thier snot, but then life would be boring. Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? -- Crowley, MD Family Medicine Cape May Courthouse NJ Patients, please allow up to 48 hours for response. If you are having an urgent problem please go to the emergency department or call 911. If you have a problem or question that can't wait 48 hours, or you have not received a timely response, just call the office at 465-0882. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2009 Report Share Posted January 22, 2009 Sure. Self pay only. Post the cost of a visit for a URI (say, $85). Now, post the cost for other things individulally.. Then have the statement "Addressing Mulitple Issues Will Result in Billing For Multiple Issues" or some such. Wayne CoghillPractice ManagerMidtown Primary Carewww.doctorcoghill.com To: Sent: Thursday, January 22, 2009 4:09:39 PMSubject: Re: OTITIS MEDIA/URI would someone please tell me how to have someone come in for just a URI? without some sort of emotional crisis, or poorly controlled bp, or issue pertaining to some other biopsychosocial drama? tac p.s. its sort of a rhetorical question, if you don't ask the dreaded "how are you?" i think they will just stick to thier snot, but then life would be boring. Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? -- Crowley, MDFamily MedicineCape May Courthouse NJPatients, please allow up to 48 hours for response. If you are having an urgent problem please go to the emergency department or call 911. If you have a problem or question that can't wait 48 hours, or you have not received a timely response, just call the office at 465-0882. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2009 Report Share Posted January 22, 2009 What is the main symptom of their URI? Cough 786.2 Fever 780.60 Earache 388.70 Sinusitis 461.1 Rhinitis 460 It’s almost always a 99213 because of the number of systems that are involved/examined. Pratt Office Manager Oak Tree Internal Medicine P.C Roy Medical Associates, Inc. From: [mailto: ] On Behalf Of Crowley Sent: Thursday, January 22, 2009 1:10 PM To: Subject: Re: OTITIS MEDIA/URI would someone please tell me how to have someone come in for just a URI? without some sort of emotional crisis, or poorly controlled bp, or issue pertaining to some other biopsychosocial drama? tac p.s. its sort of a rhetorical question, if you don't ask the dreaded " how are you? " i think they will just stick to thier snot, but then life would be boring. On Mon, Jan 19, 2009 at 5:28 PM, Chirag Patel <cpmwu2000> wrote: Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? -- Crowley, MD Family Medicine Cape May Courthouse NJ Patients, please allow up to 48 hours for response. If you are having an urgent problem please go to the emergency department or call 911. If you have a problem or question that can't wait 48 hours, or you have not received a timely response, just call the office at 465-0882. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2009 Report Share Posted January 23, 2009 it must be new jersey... tac Yeah, Don't ask me. I was lamenting that to myself just last night. Could I please have a simple Htn recheck? Even the URI was also umbilical hernia and sore elbow. Something easy, I feel good, here are you meds. Good bye. That would be so great. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypractice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: [mailto: ] On Behalf Of Crowley Sent: Thursday, January 22, 2009 4:10 PMTo: Subject: Re: OTITIS MEDIA/URI would someone please tell me how to have someone come in for just a URI? without some sort of emotional crisis, or poorly controlled bp, or issue pertaining to some other biopsychosocial drama? tac p.s. its sort of a rhetorical question, if you don't ask the dreaded " how are you? " i think they will just stick to thier snot, but then life would be boring. Can somebody please tell me if an Otitis Media/URI visit is 99212 or 99213. I really have a hard time figuring out which my acute pediatric visits are 99212 or 99213, any advice or examples for this out there? -- Crowley, MDFamily MedicineCape May Courthouse NJPatients, please allow up to 48 hours for response. If you are having an urgent problem please go to the emergency department or call 911. If you have a problem or question that can't wait 48 hours, or you have not received a timely response, just call the office at 465-0882. -- Crowley, MD Family MedicineCape May Courthouse NJPatients, please allow up to 48 hours for response. If you are having an urgent problem please go to the emergency department or call 911. If you have a problem or question that can't wait 48 hours, or you have not received a timely response, just call the office at 465-0882. Quote Link to comment Share on other sites More sharing options...
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