mc1030
Contributor
Hello all!
I have a provider asking to me to switch her code from 99214 to 99215 and after reviewing the document, it seemed to me that it met the 99214. She did prescription management and the patient had more then one chronic illnesses with her time spent total of 34 minutes. I was told that the PHQ and GAD was a standard testing that these provider do on all their visits and not considered for MDM (let me know if this isn't true).
So, I told the provider that I did not see any unique testing or assessment that met the category and that she needed at least 2 category to meet the high level. She questioned me how PHQ and GAD were not an assessment and what would be a unique testing/ assessment that is considered for Behavioral Health MDM. I tried researching some answers and checked the book but I am not getting a clear answer for it when it comes to Behavioral Health. I appreciate any advice! Thank you
I have a provider asking to me to switch her code from 99214 to 99215 and after reviewing the document, it seemed to me that it met the 99214. She did prescription management and the patient had more then one chronic illnesses with her time spent total of 34 minutes. I was told that the PHQ and GAD was a standard testing that these provider do on all their visits and not considered for MDM (let me know if this isn't true).
So, I told the provider that I did not see any unique testing or assessment that met the category and that she needed at least 2 category to meet the high level. She questioned me how PHQ and GAD were not an assessment and what would be a unique testing/ assessment that is considered for Behavioral Health MDM. I tried researching some answers and checked the book but I am not getting a clear answer for it when it comes to Behavioral Health. I appreciate any advice! Thank you