Medical Decision Making

Part I: What are the coding documentation guidelines for Level 4, specifically 99204 and 99214 using Medical Decision Making? Part 2: What level of E/M service does the treatment of a paronychia qualify for?

Can a podiatrist bill a Level 5 E/M visit?

What are the guidelines for selecting the level of E/M service based upon Medical Decision Making (MDM)?

CPT® has provided numerous definitions to clarify terms in the current guidelines, such as “chronic illness with exacerbation, progression or side effects of treatment,” and “drug therapy requiring intensive monitoring for toxicity.”

“We have a disagreement among our group regarding radiology billing. If a new patient presents with x-rays, MRI, etc., from an outside source, without a report (or with an inadequate report), can the podiatrist bill for the professional component of reading the imaging studies provided?”