Lori
Well-known member
Good Morning Coders!
What are you coding today?
High:
99205
99215
High
• 1 or more chronic
illnesses with severe
exacerbation,
progression, or side
effects of treatment;
or
• 1 acute or chronic
illness or injury that
poses a threat to life
or bodily function
Extensive
(Must meet the requirements of at least 2 out of 3
categories)
Category 1: Tests, documents, or independent
historian(s)
• Any combination of 3 from the following:
• Review of prior external note(s) from each
unique source*;
• Review of the result(s) of each unique test*;
• Ordering of each unique test*;
• Assessment requiring an independent
historian(s)
or
Category 2: Independent interpretation of tests
• Independent interpretation of a test
performed by another physician/other
qualified health care professional (not
separately reported);
or
Category 3: Discussion of management or test
interpretation
• Discussion of management or test
interpretation with external physician/other
qualified health care professional/appropriate
source (not separately reported)
High risk of morbidity from
additional diagnostic testing or
treatment
Examples only:
• Drug therapy requiring
intensive monitoring for
toxicity
• Decision regarding elective
major surgery with
identified patient or
procedure risk factors
• Decision regarding
emergency major surgery
• Decision regarding
hospitalization
• Decision not to resuscitate
or to de-escalate care
because of poor prognosis

What are you coding today?
High:
99205
99215
High
• 1 or more chronic
illnesses with severe
exacerbation,
progression, or side
effects of treatment;
or
• 1 acute or chronic
illness or injury that
poses a threat to life
or bodily function
Extensive
(Must meet the requirements of at least 2 out of 3
categories)
Category 1: Tests, documents, or independent
historian(s)
• Any combination of 3 from the following:
• Review of prior external note(s) from each
unique source*;
• Review of the result(s) of each unique test*;
• Ordering of each unique test*;
• Assessment requiring an independent
historian(s)
or
Category 2: Independent interpretation of tests
• Independent interpretation of a test
performed by another physician/other
qualified health care professional (not
separately reported);
or
Category 3: Discussion of management or test
interpretation
• Discussion of management or test
interpretation with external physician/other
qualified health care professional/appropriate
source (not separately reported)
High risk of morbidity from
additional diagnostic testing or
treatment
Examples only:
• Drug therapy requiring
intensive monitoring for
toxicity
• Decision regarding elective
major surgery with
identified patient or
procedure risk factors
• Decision regarding
emergency major surgery
• Decision regarding
hospitalization
• Decision not to resuscitate
or to de-escalate care
because of poor prognosis
