New patients and follow-ups

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Estimating - what % of your new patient visits are 99203 vs 99204 and what % of your follow ups are 99213 vs 99214?

 

[mdo1738]

I have only ever had one 99203. That was a patient who did not, in fact, have pain. Everything else has been a 4.

Follow ups are probably 85-90% level 4, 10-15% 3s.

 

[cowboydoc]

In 2023, I was <1% 99205, 7% 99203, 92% 99204. 1% 99215, 17% 99213, 83% 99214.

 

[bedrock]

Anyone who I can’t help but isnt looking for opioids or a complicated second opinion is a 99203.

1-The worried well, patients with mild intermittent disc pain who have already failed PT.

2- Medicaid patients with more mental problems than medical problems, so quick visit to say I can’t help them.

3- Obese patients axial pain, <40yrs. Quickly tell them gently that there is no easy magic bullet, they have to lose 50-150 lbs, period if they want less pain.

Those all take less than 6 minutes and so I can’t justify a level 4.

 

[callmeanesthesia]

Anyone who I can’t help but isnt looking for opioids or a complicated second opinion is a 99203.

1-The worried well, patients with mild intermittent disc pain who have already failed PT.

2- Medicaid patients with more mental problems than medical problems, so quick visit to say I can’t help them.

3- Obese patients axial pain, <40yrs. Quickly tell them gently that there is no easy magic bullet, they have to lose 50-150 lbs, period if they want less pain.

Those all take less than 6 minutes and so I can’t justify a level 4.

While I know where you’re coming from not feeling like a level 4 is justified, it probably is based on MDM criteria. To arrive at those conclusions you’ve reviewed the referring provider’s note, reviewed their imaging (and probably personally reviewed the images), and the patient has multiple chronic conditions that are impacting their functionality.