Billing: Difference between revisions

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*History of Present Present Illness Illness (HPI)
===History of Present Present Illness Illness (HPI)===
**Location
*Location
**Severity
*Severity
**Timing
*Timing
**Modifying Factors
*Modifying Factors
**Associated Associated Signs and Symptoms Symptoms
*Associated Associated Signs and Symptoms Symptoms
**Onset
*Onset
**Quality
*Quality
**Duration
*Duration


*Past Medical, Family, Family, Social History  
===Past Medical, Family, Family, Social History===
**Past Medical
*Past Medical
***Past Illnesses
**Past Illnesses
***Major Injuries
**Major Injuries
***Surgical History
**Surgical History
***Hospitalizations
**Hospitalizations
***Immunizations
**Immunizations
***Feeding/Dietary
**Feeding/Dietary
**Family History
*Family History
***Health Status
**Health Status
***Deaths
**Deaths
***Hereditary Diseases
**Hereditary Diseases
**Social History
*Social History
***Drug, etoh , tobacco
**Drug, etoh , tobacco
***Employment
**Employment
***Marital Status
**Marital Status
***Sexual History
**Sexual History


==RVU For Level of Service<ref>http://www.acep.org/Clinical---Practice-Management/Top-20-ED-Reimbursement-Codes-2016/</ref>==
==RVU For Level of Service<ref>http://www.acep.org/Clinical---Practice-Management/Top-20-ED-Reimbursement-Codes-2016/</ref>==

Revision as of 22:31, 22 January 2017

CMS Requirements for Billing

99281 99282 99283 99284 99285
Level1 Level 2 Level 3 Level 4 Level 5
HPI 1 of 8 1 of 8 1 of 8 4 of 8 4 of 8
ROS 0 1 1 2 10
PMHx, FamHx, Social Hx 0 0 0 1 2
PE 1 2 2 5 8
MDM Straight‐forward Low Complexity Moderate Complexity Moderate Complexity High Complexity

History of Present Present Illness Illness (HPI)

  • Location
  • Severity
  • Timing
  • Modifying Factors
  • Associated Associated Signs and Symptoms Symptoms
  • Onset
  • Quality
  • Duration

Past Medical, Family, Family, Social History

  • Past Medical
    • Past Illnesses
    • Major Injuries
    • Surgical History
    • Hospitalizations
    • Immunizations
    • Feeding/Dietary
  • Family History
    • Health Status
    • Deaths
    • Hereditary Diseases
  • Social History
    • Drug, etoh , tobacco
    • Employment
    • Marital Status
    • Sexual History

RVU For Level of Service[1]

  • 99281 (Level 1) = 0.60 RVUs
  • 99282 (Level 2) = 1.17 RVUs
  • 99283 (Level 3) = 1.75 RVUs
  • 99284 (Level 4) = 3.32 RVUs
  • 99285 (Level 5) = 4.90 RVUs
  • 99291 (Critical Care) = 6.31 RVUs 1st hr
    • Critical Critical care can be coded when the total duration duration of time spent by a provider in providing critical care services to a critically ill or critically injured patient is at least 30 minutes, even if the time spent is not continuous.

See Also

References