A patient in an assisted living facility is under the care of a physician for atrial fibrillation requiring Coumadin, which requires frequent laboratory checks. She is also a brittle diabetic requiring frequent blood sugar checks and insulin adjustments, which routinely involves telephone calls to the physician from the facility. Because of COPD, she is on continuous oxygenation and routinely needs medication adjustments and breathing machine adjustments to maintain her oxygen levels. The physician is typically called 3-4 times a week, despite routine orders onsite for the nurses, and he then has to spend time talking with his patient’s daughter about the changes to her mother’s care. He spends more than 30 minutes a month doing all of this. What is the correct evaluation and management code for this type of encounter?
