Charlene Posted Tue 30th of June, 2015 15:19:20 PM
I'M TRYING TO LOCATE MEDICARE GUIDELINE WHICH EMPHASIZES THE NEED FOR MODERATE TO HIGH LEVEL OF MEDICAL NECESSITY TO SUBSTANTIATE THE SELECTION OF 99214 & 99215 RATHER THAN JUST DOCUMENTING DETAILED OR COMPREHENSIVE HX AND EXAM TO SATISFY THE 2 OUT OF 3 COMPONENT CRITERIA.
ALSO, LOOKING FOR AUDIT SHEET TO CAPTURE THE OVERALL HX, EXAM, DM, TIME.
SuperCoder Answered Wed 01st of July, 2015 03:05:50 AM
Well, medical necessity checked while selecting the MDM risk i.e. nature of present illness (NPI). For making the final level of E&M for established patient it is necessary to select the 2 out of 3 component. For complete guidelines you can go through CMS website- http://www.cms.gov.
Hope it helps!