Michael last visited his physician, which is a single-physician office practice, in September 2006. He is at the office today for a sore throat and chest congestion. Since he was already a patient, the medical insurance coder submitted an established patient E/M code to Michael's insurance carrier for payment. The insurance carrier requested additional documentation regarding the visit. Which of the following may have been the reason?
A. Michael's visit should have been coded from the new patient E/M category.
B. The medical insurance coder did not submit the claim to the insurance carrier on the actual day of Michael's visit.
C. There was no reason for the insurance carrier to request the additional documentation.
D. Michael's visit should have been coded from the HCPCS code selections.
Answer: A
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