Forum - Questions & Answers

May 8th, 2014 - mary77 2 

E/M codes

Hello; for 99214 established patient , every where I read we need 2 out of 3 key components, what it that means?
the 3 component is
1-HPI
2-Exam
3-MDM

If our 1-HPI :detailed & 2- Exam :detailed does that mean we covered the 2 components out of 3 & we can bill 99214?

May 8th, 2014 - jvosfernea 66 

re: E/M codes

HPI is the history/Sx's/etc of the presenting illness, and all of the components required of listing these;
Exam also has required components specific to each of the 99212/22913/99214/99215 levels of interaction and contact;
MDM is the level of Medical Decision Making required, and 99214 is the next to the highest level in terms of requiring information about this.
The American Academy of Child & Adol Psychiatry has a very nice table on these items and what is required at each level to answer your question, as you must completely meet the components of two out of the three, or your eval will not pass reimbursement muster at all. You can find their table on their own website, or through the National Council on Behavioral Healthcare website.



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