NOV 02, 2020
Audit Tool Applied to Eye Visit Codes
Question: Our compliance department is in the process of reviewing our new patient Eye visit codes, and they are down-coding our comprehensive codes to intermediate exams because we are missing the review of systems and past, family and social histories. Do we need to have this documentation?
Answer: The compliance department is inappropriately applying the 1997 E/M guidelines to the 1983 Eye visit codes. Eye visit codes require a history and general medical observation which is not defined further. Beginning Jan 1, 2021, only a medically relevant ROS, PFSH and elements to the HPI must be performed.