Linda Barbar asked:
Hi;
i need help please with the following examples:
In _initial hospital care_; the physician performs a comprehensive history; comprehensive exam and a high complexity medical decision making
99221:
Detailed or comprehensive history
Detailed or comprehensive Examination
MDM straightforward or low complexity.
99222:
Comprehensive history
Comprehensive Examination
MDM moderate complexity.
99223:
Comprehensive history
Comprehensive Examination
MDM high complexity.
to get the HEM.
H:could be 1 or 2 or 3
E:could be 1 or 2 or 3
M: 2
and in initial hospital care we have 3 of 3; which means code to the lowest .... so how am i supposed to choose the lowest? is it the first or second level?
thank you
Answer:
Answered in comments (quite well) by Tiffany Baca: Codes 99221-99223 are initial hospital codes that the admitting (attending) physician would use and not emergency codes. Emergency codes are 99281-99285; so I am a bit confused. But lets say it was for a new patient and the admitting physician gave a HEM of DCH. Since all the HEM components are not met; for 3 out of 3 you would code to the lowest code which would be 99221. For your second question; the HEM is CCM which the correct code would be 99235. Remember; when it comes to 3 out of 3 and all components of the HEM are not met; you code to the lowest.
Followup question:
thank you for your answer; the mentioned example are two different questions.
What i am asking about is the technique Leureens taught us in the blitz to find the E/M code .........
to get the HEM; we would assign the number of of the level of each HEM so i can use 3 of 3"code to the lowest" and 2 of 3 " throw out the lowest"
for example for the first example in emergency; the medical decision making is high; so we assign 3
now; what about history code? should i assign 1 or 2 or 3 ?? same for examination
Followup answer:
Is this what you were referring to?
For the first question:
D for history = level 1
C for exam = level 1 or level 2
H for MDM= level 3
For the second question:
C for history = level 2
C for exam = level 2
M for MDM = level 3
* I see where you are getting confused with the history and exam both being Comprehensive and all three codes have a Comprehensive history and exam. You are always going to go with the higher level code when leveling. However; in your scenario; you are not having to level because the HEM of CCH meets all the components of 99223.
History comprehensive
Hi;
i need help please with the following examples:
In _initial hospital care_; the physician performs a comprehensive history; comprehensive exam and a high complexity medical decision making
99221:
Detailed or comprehensive history
Detailed or comprehensive Examination
MDM straightforward or low complexity.
99222:
Comprehensive history
Comprehensive Examination
MDM moderate complexity.
99223:
Comprehensive history
Comprehensive Examination
MDM high complexity.
to get the HEM.
H:could be 1 or 2 or 3
E:could be 1 or 2 or 3
M: 2
and in initial hospital care we have 3 of 3; which means code to the lowest .... so how am i supposed to choose the lowest? is it the first or second level?
thank you
Answer:
Answered in comments (quite well) by Tiffany Baca: Codes 99221-99223 are initial hospital codes that the admitting (attending) physician would use and not emergency codes. Emergency codes are 99281-99285; so I am a bit confused. But lets say it was for a new patient and the admitting physician gave a HEM of DCH. Since all the HEM components are not met; for 3 out of 3 you would code to the lowest code which would be 99221. For your second question; the HEM is CCM which the correct code would be 99235. Remember; when it comes to 3 out of 3 and all components of the HEM are not met; you code to the lowest.
Followup question:
thank you for your answer; the mentioned example are two different questions.
What i am asking about is the technique Leureens taught us in the blitz to find the E/M code .........
to get the HEM; we would assign the number of of the level of each HEM so i can use 3 of 3"code to the lowest" and 2 of 3 " throw out the lowest"
for example for the first example in emergency; the medical decision making is high; so we assign 3
now; what about history code? should i assign 1 or 2 or 3 ?? same for examination
Followup answer:
Is this what you were referring to?
For the first question:
D for history = level 1
C for exam = level 1 or level 2
H for MDM= level 3
For the second question:
C for history = level 2
C for exam = level 2
M for MDM = level 3
* I see where you are getting confused with the history and exam both being Comprehensive and all three codes have a Comprehensive history and exam. You are always going to go with the higher level code when leveling. However; in your scenario; you are not having to level because the HEM of CCH meets all the components of 99223.
History comprehensive
Last edited: