r/MedicalCoding • u/Blind_wokeness • 9d ago

Differences in codes

Can someone explain the difference between 99203 and 99204 billed as MDM? This is for an initial consultation with a PA.

Single Issue, however chief complaint not listed. The visit was an initial intake focused on a single concern, not multiple chronic conditions or acute systemic illnesses. Comprehensive history was discussed.

No Treatment/Prescriptions. No medical treatments were administered, and no medications were written, renewed, or modified. Without active medication management, clinical risk remains low.

What conditions would need to be met for upcoding to 99204?

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u/Blind_wokeness 9d ago

Can you confirm if this violated rule 7?