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Posts: 2
Reply with quote  #1 
This may seem like a very straight forward and simple question but when choosing the final E/M code, when the elements are all in different columns, do you choose the lowest element for new patients and then for established patients, do you drop the lowest element and go with the next lowest, so it ends up being where you would choose the middle.
For example, if a new patient visit had History as PF, Exam as EPF, and MDM as moderate, would the code be 99201 based on the fact that history is the lowest, so we code to the lowest. 
For established patients, if History was PF, Exam EPF, and MDM moderate the code would be 99213 because I dropped the lowest and the next lowest is EPF which is 99213?
Any help would be great.  Thank you.

Posts: 33
Reply with quote  #2 
You have to meet or exceed each level to select it (so your comment of going with lowest is correct for new patients).  For established, it's only 2 of the 3 components. 

In your example for NP that's also correct.  And in your example for established, you could use EPF exam an MDM that's moderate and you would get (as you mention) 99213.

So for new patient's; if you have a brief HPI, expanded problem focused exam and MDM that's moderate, you only meet/exceed brief in all 3 components. 

Most places/companies want MDM to be one of the 2 elements with established patients.  

Hope that helps

Posts: 2
Reply with quote  #3 
Thank you for the response, so for established patients, would I go with the lowest element as well or drop the lowest and go with the middle element.  I've been advised of both ways.

Thank you.
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