Rheumatology Coding Corner Answer: Level 4 New Patient Visit

Correct Answer:

CPT: 99204
ICD-10: I73.00

Coding Rationale

This is a new patient, outpatient visit for a self-referred patient. There is no formal consultation request from another physician; therefore, the encounter does not meet criteria for a consultation.

This encounter is coded as 99204 because it included:

Comprehensive history—Extended history of the present illness, complete review of systems and complete past family social history were documented.
Comprehensive examination—12 systems.
Moderate complexity decision making—New problem with additional workup planned; extensive laboratory studies ordered; prescription medication therapy initiated.

The ICD-10 code I173.00 is for Raynaud’s phenomenon without gangrene.

The ICD-10 page on the Centers for Medicare & Medicaid Services (CMS) website features a countdown clock that shows the time left until Oct. 1, 2015, the date on which compliance with the new code set becomes mandatory. By the time this issue goes to press, the clock will read 90 or fewer days. Time…

Coding changes will have an impact on staff, physicians, and even the finances of rheumatology practices

ICD-10 will change the coding and billing landscape, and practices should start preparing now

The transition to ICD-10 is not just another yearly diagnosis codes update; it is a complete overhaul. This not only will affect providers, but also all payers, vendors and stakeholders are being affected by the expanded ICD-10 code sets through medical coding operations, software systems, reporting, administration, registration and more. With approximately 20 days before…

Rheumatology Coding Corner Answer: Level 4 New Patient Visit

Coding Rationale

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Coding Rationale

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