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Initial Visit
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F/U medical Visit
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F/U
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Problems Addressed
• • •
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Time Based Coding
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MDM Based Coding
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Time Based Billing
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Time Spent (if under 70 min)
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Prolonged Visit (if= >70minutes)
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Prolonged Visit 70-84 min (PPO)
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Prolonged Visit 70-84 min (medicare)
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Prolonged Visit 85-99 min (PPO)
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Prolonged Visit 85-99 min (medicare)
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Prolonged Visit >100 min (PPO)
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Prolonged Visit >100 min (medicare)
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Activities
• • •
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Incident to me
• • •
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MDM Billing
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# Problems
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Data Reviewed
• • •
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Low Risk (lifestyle intervention only)
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Moderate Risk (medication, minor procedure, or socially complicated)
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High Risk (major surgery or hospitalization)
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99212 (Problems=2, Data=0, Risk=low)
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99213 (Problems=3,Data =1. Risk=low)
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99214(Problems =4, Data =2, Risk=Moderate)
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99215 (Problems =5, Data = 4, Risk =High)
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Initial
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Preventive Exam (In-Person Only. PPO only)
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Telehealth Initial
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Initial with Preventive
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Patient's BMI and Category
• • •
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18-39 age
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40-64 age
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>65 age
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Time Based EM W P
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MDM Intial EM w P
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Time based Billing
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15–29 E/M
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30–44 E/M
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45–59 E/M
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60–74 E/M
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MDM based Billing
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|
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# Problems
|
Data Reviewed
• • •
|
|
Low Risk (lifestyle intervention only)
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Moderate Risk (medication, minor procedure, or socially complicated)
|
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High Risk (major surgery or hospitalization)
|
|
|
99202 (Problems=2, Data=0, Risk=low)
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99203 (Problems=3,Data =1. Risk=low)
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99204 (Problems =4, Data =2, Risk=Moderate)
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99205 (Problems =5, Data = 4, Risk =High)
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TIme Based Intial w/o Preventive
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MDM initial w/o preventive
|
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Time based Billing
|
|
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15–29 E/M
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30–44 E/M
|
|
45–59 E/M
|
60–74 E/M
|
|
MDM based Billing
|
|
|
# Problems
|
Data Reviewed
• • •
|
|
Low Risk (lifestyle intervention only)
|
Moderate Risk (medication, minor procedure, or socially complicated)
|
|
High Risk (major surgery or hospitalization)
|
|
|
99202 (Problems=2, Data=0, Risk=low)
|
99203 (Problems=3,Data =1. Risk=low)
|
|
99204 (Problems =4, Data =2, Risk=Moderate)
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99205 (Problems =5, Data = 4, Risk =High)
|
|
EM Problems
• • •
|
|
|
Time Activities
• • •
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Incident to me
• • •
|
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Time Activities
• • •
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Incident to me
• • •
|
