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kristydews

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Posts: 1
Reply with quote  #1 
A patient has a detailed -HPI, C-Exam- and H- MDM
And they was admitted . Because they have a detailed HPI it wouldn't still qualify them for the 99285 ? Just because a patient gets admitted does it qualify them for 99285 even though everything else does not add up to it?
ShoshanaRuth

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Reply with quote  #2 
At our facility, acuity drives the level of service billed. With that said, the elements must be there to reach the CPT documentation requirements.  In the ED, the documentation must meet all 3 key elements.  If the HPI only meets a detailed, even if it is high acuity, the patient would be billed 99284 and the physician educated on what was missing.  An admission is not an automatic 99285.
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