Coding and Billing Flashcards
1
Q
What constitutes a low complexity eval?
A
No personal factors or comorbidities, 1-2 exams of body systems, stable condition, and low complex decision making.
2
Q
What constitutes a moderate complexity eval?
A
1-2 personal factors or comorbidities, 3 or more exams of body systems, evolving condition, moderately complex decision making.
3
Q
What constitutes a high complexity eval?
A
3 or more personal factors/comorbs, 4 or more body systems exams, unstable condition, and high complexity decision making.
4
Q
What is the general concept of Substantial Portion Methodology (SPM) billing?
A
If you exceed HALF of the 15 minute code, you can use the code. It does not consider total time.
5
Q
Can you use SPM billing for federal payers?
A
No
