The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Rheumatology Coding Question: Deconstructing Evaluation and Management Codes

Rheumatology Coding Question: Deconstructing Evaluation and Management Codes

January 19, 2017 • By From the College

  • Tweet
  • Email
Print-Friendly Version / Save PDF
    1. A 50-year-old male patient returns to the office for a follow-up visit for a diagnosis of generalized primary osteoarthritis of multiple sites. The patient tells the medical assistant that he is experiencing sharp throbbing pain in his left hip and right and left knees. He states the pain level is 6 out of 10 and lasts for about an hour in the morning. Would this history of present illness (HPI) be acceptable?
      1. Yes
      2. No
    2. An established patient is on a high-risk medication. Would the medical decision making be high risk for this patient?
      1. Yes
      2. No
    3. The medical decision making states the patient is assessed with having rheumatoid arthritis that is RF negative of multiple sites. The treatment plan is to continue with 10 mg of methotrexate, and the patient is scheduled for their first infliximab infusion in two weeks. The patient is assessed with having generalized osteoarthritis of the left knee. The treatment plan is to have the patient schedule an MRI of the left knee. It is also documented that the patient has comorbidities of diabetes and hypertension. Which ICD-10 codes should be coded?
      1. M06.09, M17.12
      2. M06.09, M17.12, E11.9
      3. M06.09, M17.12, E11.9, I10
      4. None of the above
    4. A new rheumatologist has joined the practice and brings some of her established patients from her former practice. If one of the other rheumatologists sees one of the established patients for the first visit, how should the visit be billed?
      1. New patient
      2. Established patient
    5. A midlevel provider is seeing an established patient, but during the visit the patient complains of a new problem. The supervising physician is busy with another patient and cannot assess the new problem, so it is decided that the midlevel provider can treat the problem and not bill the service as incident-to. The patient returns to the practice four weeks later with the same problems from the last visit. Can this now be coded as an incident-to visit without the supervising physician’s input?
      1. Yes
      2. No

Click here for the answers.

You Might Also Like
  • Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes
  • Rheumatology Coding Question: Level 3 Established Patient Evaluation and Management Office Visit
  • Rheumatology Coding Answer: Level 3 Established Patient Evaluation and Management Office Visit
Explore This Issue
January 2017
Also By This Author
  • American College of Rheumatology (ACR) on Capitol Hill

Filed Under: Billing/Coding, From the College, Practice Management Tagged With: Billing, Coding, Documentation, Evaluation, exam, Management, patient care, Practice Management, rheumatologyIssue: January 2017

You Might Also Like:
  • Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes
  • Rheumatology Coding Question: Level 3 Established Patient Evaluation and Management Office Visit
  • Rheumatology Coding Answer: Level 3 Established Patient Evaluation and Management Office Visit
  • How to Manage Denials of Evaluation and Management Coding for New Rheumatology Patients

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.