Difference between ...

[bkpa2med]

a level 2, level 3 and level 4 visit?

What is the difference and what type of visits are these generally speaking?

Which one would you most frequent?

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[bkpa2med]

anyone?

 

[deleted87716]

99212 ("level 2") is the lowest-level visit a physician would bill for an established outpatient visit, and is essentially a single, simple problem requiring minimal ROS, an extremely limited exam, and no prescription drug management (e.g., advice or OTC treatment only). I rarely code those.

My average visit is a 99214 ("level four"). The only difference between a 99214 and 99215 ("level five") is risk. If a patient is complex enough, or their problems are serious enough, you can justify a 99215. You just have to make sure your documentation meets the requirements for whatever level visit that you code.

The biggest decision point for most primary care visits is whether to code a 99213 or 99214. This article may help with that: http://www.aafp.org/fpm/20050900/52codi.html

 

[YouDontKnowJack]

you do mostly level 4?

ooooo. you must be comfortably rich. those suckers are $150-250 right?

 

[bkpa2med]

99212 ("level 2") is the lowest-level visit a physician would bill for an established outpatient visit, and is essentially a single, simple problem requiring minimal ROS, an extremely limited exam, and no prescription drug management (e.g., advice or OTC treatment only). I rarely code those.

My average visit is a 99214 ("level four"). The only difference between a 99214 and 99215 ("level five") is risk. If a patient is complex enough, or their problems are serious enough, you can justify a 99215. You just have to make sure your documentation meets the requirements for whatever level visit that you code.

The biggest decision point for most primary care visits is whether to code a 99213 or 99214. This article may help with that: http://www.aafp.org/fpm/20050900/52codi.html

Thanks, just out of curiosity, would an IM doc see more level 4's, since relatively speaking FM docs treat a healthier population?

 

[bkpa2med]

BTW, thanks Kent that article was an interesting read where it gave scenarios.

Honestly, I would assume that would be most of the population since people don't really like to follow doctors orders

 

[deleted87716]

you do mostly level 4?

Most family physicians do mostly level four visits, they just don't know how to code properly in order to get paid for the work they're doing.

Thanks, just out of curiosity, would an IM doc see more level 4's, since relatively speaking FM docs treat a healthier population?

I imagine that would be practice-dependent. My population is mostly "internal medicine," older adults with multiple problems.

Don't equate "primary care" to "simple care."

 

[bkpa2med]

Concerning population, how can you select the type you want to treat. Don't people assume an FM treats cradle to the grave?

 

[deleted87716]

Concerning population, how can you select the type you want to treat. Don't people assume an FM treats cradle to the grave?

Well, in my case, you "select" it by taking over for a retired physician.

In medicine, as in many other fields, there's an 80/20 rule, meaning that 80% of your business comes from 20% of your clientele. Your older patients come in more often simply because they need to, even if they're not the majority of your population. I have plenty of relatively young, healthy patients who I see maybe once a year, or once every couple of years for a physical or some sort of acute problem. It's the seniors who are really paying the bills.

 

[bkpa2med]

Interesting. I learn something new everyday and it's great that you actually provide crucial insight to those of us looking for some. So, if an FM doc catered to geriatric patients, there would be more level 4's and more patients from your total clientele?

 

[deleted87716]

Interesting. I learn something new everyday and it's great that you actually provide crucial insight to those of us looking for some. So, if an FM doc catered to geriatric patients, there would be more level 4's and more patients from your total clientele?

Even relatively young patients can generate plenty of level four visits. You just have to accurately account for the level of complexity that the visit entails. Too many physicians sell themselves short in this regard. Just because we've done something a thousand times and it no longer seems hard to us, doesn't mean that it's no longer complex.

 

[bkpa2med]

I see.