WHEN HOSPITALISTS CHOOSE CPTcodes to reflect medical complexity, they tend to think only of patients’ medical risk, but factors like the patient’s diagnosis, management options and the amount and complexity of data are also important factors. While risk is important, it’s only one of three...
Therefore, when coding, it is imperative that the only codes that are contained in a claim are codes that have evidence for usage in the medical record. It is never acceptable to infer or assume that a procedure has been done or a diagnosis made. Billing accuracy often increases when EMR ...
Coding for well visits is much trickier. Well visit codes will be shown as 9938x or 9939x, where x is again 1-5 but now represents the age of the patient. “Typical” resources needed are fairly consistent from age to age so CPT E/M codes define a “typical minimum” that must be ...