Medical Billing Forum
Coding => Coding => : mooreq July 28, 2009, 01:41:07 PM
-
Hi,
I need to know the "official" guidelines for coding a new patient examination. IE, if I have a 99203 or a 99204 level service, what exactly must be included.
NJ Manufacturers is saying that a full, computerized Range of Motion examination is to be performed within a 99203/99204 level examination. The physician indicates that he can use an observed Range of Motion for the exam, and then do a separate procedure for the computerized testing (95851 per trunk section) on a different day.
The physician's code book says: "Routine muscle and range of motion testing is a component of a physical examination within the E/M service. However, in such routine examinations there could be findings that indicate a need for more definitive and quantifiable data. In such cases, these "separate procedure" codes are appropriate and accurate expressions."
so it boils down to this: can anyone help me find the official text describing the range of motion examination component for an E/M code so a chiro can use the observed range of motion on normal intake exams, and a separate ROM code on a subsequent visit
I have tried the NJ State site for banking and insurance. They have a fee schedule but no info on what is to be included in E/M svc. codes. Any guidance would help!
Thanks, JM
J
-
This is a tough one. I don't have an answer for you. I hope we have another forum member with experience in this.
Michele
-
Try this links. It may help !
http://www.aaos.org/news/bulletin/may07/managing7.asp
http://www.aaos.org/news/bulletin/may07/davidson_tables.pdf
http://www.cms.hhs.gov/mlnproducts/downloads/master1.pdf
-
Thanks for the reply Philip!
-
Evaluation and Management Documentation Guidelines were published in 1995 AND 1997. Thes two guidelines are industry standard and are mandated by HIPAA by CMS. They are located here:
http://www.cms.hhs.gov/MLNEdwebGuide/25_EMDOC.asp
a 99203 and 99204 requies the three key components of the E/M: History, Examination and Medical Decision Making.