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Click here for more sample CPC practice exam questions and answers with full rationale

New Patient/ Flu only but coding a level of service

For this flu season I am seeing new patients who are only coming in to receive a flu shot having to book an office visit with a provider. They are dropping a level of service code (E&M code EG: 99201-99205), the flu vaccine and the flu administration code. The patient has no chief complaint or history of present illness. They are simply in Office to establish care since they are new patients and are in Office to only receive a flu shot. I know we should not code a level of service but need to convince someone who does not understand how to code that this is wrong. They think that bc the provider reviewed the patients past medical history and did a physical exam then we can code for a level of service. My deal is there is no HPI or ROS… yes they have PFSH but bc we are missing the HPI & ROS then we do not hit the elements in History. And for a new patient to receive a level of service we must hit all three elements (History, Exam & MDM) but when I tell them this it goes over their head. How can I convince them they are wrong? Is there a law or compliance or maybe a case of a practice doing this and getting in trouble? As a CPC I do not want to push these through.

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