When Coding, Remember: ‘Necessity’ Is in the Eye of the Beholder

When Coding, Remember: ‘Necessity’ Is in the Eye of the Beholder

Providers are employing evaluation and management (E/M) code 99214 more than ever—and seeing fewer denials and higher reimbursements than in the past, ultimately. That doesn’t mean it’s open season on the higher level code (and associated higher reimbursements), however; documenting medical necessity sufficiently is still critical to ensuring the code is valid compared with the reigning most common code (99213). Operators must ensure coders understand that while a level 3 visit requires one to three …

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