TeddyCare ClaimIQ
INTERNAL
Amanda Rivera — Medical Coder
AR

Code Review — Maria Gonzalez

Review AI-suggested codes and approve for billing

Visit Notes

ENCOUNTER NOTE Patient: Maria Gonzalez | DOB: 03/15/1968 DOS: 01/15/2025 | Provider: Dr. Sarah Chen, MD CHIEF COMPLAINT: Follow-up diabetes management. Increased fatigue, ankle swelling x3 weeks. HISTORY: T2DM diagnosed 2012. Metformin 1000mg BID, Lisinopril 20mg. Last A1C: 8.2%. CKD Stage 3a, eGFR 48. EXAM: BP 148/92, Weight 187 (up 4 lbs), bilateral ankle edema 1+, decreased monofilament sensation bilateral feet. ASSESSMENT: 1. T2DM with diabetic CKD — poorly controlled 2. Hypertension — not at goal 3. Peripheral neuropathy — stable PLAN: Increase Metformin to 1500mg, add Jardiance. Adjust Lisinopril to 40mg. Nephrology referral. CMP + A1C in 4 weeks. Dietary counseling 30 min. Time: 35 min, >50% counseling/coordination
Review Progress0 of 4 codes reviewed

Diagnosis & Procedure Codes

E11.65
T2DM w/ CKD
98%
AI Reasoning: Selected because visit notes document "Type 2 diabetes with diabetic chronic kidney disease" and eGFR 48. EOB confirms CKD monitoring supports moderate-high complexity.
I10
Hypertension
99%
AI Reasoning: Selected because BP 148/92 documented as "not at goal." Hypertension is actively managed.
G62.9
Polyneuropathy
87%
AI Reasoning: Selected for documented decreased monofilament sensation. However, E11.42 may be more specific since diabetes is the underlying cause. EOB covers diabetic neuropathy screening.
99214
Office visit moderate
96%
AI Reasoning: 35 min visit, 3 active diagnoses, medication changes, referral coordination. Meets moderate complexity. EOB confirms no prior auth needed for E/M.