Bill Dacey

Articles by Bill Dacey

Level 5 Cases

This pediatric cardiologist thinks that all his patient visits should be coded as level 5s. Is he right?

I have a physician who saw a patient for a preventive visit and also charged a 99215 for this patient on the same date of service. He used the same documentation for both visits. Should he have documented each service separately?

Level 5 codes based on "breadth of management" need to clearly explain "why" the reported illnesses pose significant risk to patients. Should the physician add a statement to to her assessment that explains why the combination of multiple chronic illnesses pose a risk to the patient's morbidity/mortality?

A discussion arose between the auditors in my office regarding "double dipping" and I am wondering if you would mind clarifying something for us. One auditor says that it is permissible to obtain a review of systems (ROS) from the CC of "arm pain" - using arm as the location in the HPI and pain as the ROS under MS. I have never audited in this manner and would appreciate any advice or direction you can offer.

EKG Inquiry

When counting points for the data reviewed in E&M, do you count "independent review of image, tracing, or specimen" (two points), for example, when a cardiologist sees a patient, interprets an EKG, and provides an E&M service?

I know that there are going to be significantly more codes with ICD-10, but will the rules change regarding how codes are assigned?

I keep hearing about the new modifier 33 but it's not in the CPT manual. Am I supposed to be using it?

Cert Reviews

Have the rules changed for CERT (Comprehensive Error Rate Testing) reviews?