Level of Medical Decision Making

Part I: What are the coding documentation guidelines for Level 4, specifically 99204 and 99214 using Medical Decision Making? Part 2: What level of E/M service does the treatment of a paronychia qualify for?

“Based on your experience with the new E/M guidelines, is it possible and appropriate for a podiatrist to bill a level 4 or 5 if the documentation is supported? These higher levels have always been taboo (especially level 5). Some patients are at a higher risk with diabetes, chronic non-healing ulcers and wounds etc. Some patients need amputations. Based on the documentation, I believe achieving these higher levels is possible.”