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E/M Question

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CCO_Admin

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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
 
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