commit a0cd5cea20401fba1eaaaf7cb59e6ad59ad114a2
parent d1507179df16a9a6ff65bdfabe07a9a5a99df6f9
Author: C. Beau Hilton <cbeauhilton@gmail.com>
Date: Thu, 27 Aug 2020 11:05:26 -0500
memex update
Diffstat:
1 file changed, 9 insertions(+), 4 deletions(-)
diff --git a/learn/2020-08-27-coding-billing-yakes.md b/learn/2020-08-27-coding-billing-yakes.md
@@ -45,7 +45,8 @@ not necessarily including hospital fees, etc.
Average clinic day:
12 pts, ~2 $75, ~8 $110, ~2 $150 = ~$150 + $880 + $300 = ~$1330/day produced per provider
-99213 ("level 3") - ~$75
+99213 ("level 3") ~$75.
+
- 1 HPI (pt is here for sore throat)
- 1 ROS (pt denies fever or chills)
- no PFSH
@@ -55,7 +56,8 @@ Average clinic day:
- review 2 pieces of data or use an independent historian (e.g. collateral from spouse)
- low risk tx and dx tests (e.g. OTC, simple PE maneuvers)
-99214 ("level 4") - ~$110 (annual physical also about this amount)
+99214 ("level 4") ~$110 (annual physical also about this amount).
+
- this is the level to keep in mind for notes, even if the MDM is level 3, just to cover your bases
- 4 HPI (1. pt has not had CP or SOB, 2. pt has had normotension, 3. pt has been compliant with their medicines, 4. something else)
- 2 ROS
@@ -66,7 +68,8 @@ Average clinic day:
- review 3 pieces of data (inc ind historian), or interpret (I reviewed the CXR and do not see pna) (it's also ok to be wrong, just give good-faith effort) (lab data doesn't count, has to be radiographic or similar), or confer (does not have to be verbal conference - could be chart review of specialist's note)
- moderate risk tx and dx tests (rx meds - could be "cont lisinopril", social determinants limit options, elective surgery w/o major risks)
-99215 ("level 5") - ~$150
+99215 ("level 5") - ~$150.
+
- 4 HPI
- 10 ROS
- 2 PFSH
@@ -77,7 +80,8 @@ Average clinic day:
- higher risk tx or dx (rx req monitoring e.g. coumadin/opioids/chemo, hospitalization, emergent surgery)
-Annual physical - ~$110
+Annual physical - ~$110.
+
- No CC/HPI
- 14 ROS
- PMH, FH, SH (c/p or "mark as reviewed" is sufficient)
@@ -96,6 +100,7 @@ Annual physical - ~$110
- can also bill for annual + problem (e.g. 99396 Z00.00 + 99213 R07.89 [CP])
Coding based on counseling time
+
- Lvl 3: 15min
- Lvl 4: 25min
- Lvl 5: 40min
