Tag: E&M guidelines


Medical Coding Audits: Trends and Guide for Physicians

You’ve received a request for medical records from a payer, who is going to conduct an audit on your claims. Your Electronic Health Record (EHR) system is excellent, the notes are voluminous, your providers are well-versed at coding. If anything, you under code! You provide excellent care for your patients and achieve great outcomes. No […]
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Important 2023 E&M Code Changes for Prolonged Services

Among the changes are a new code for reporting prolonged services in the inpatient or observation setting and significant guideline revisions. The American Medical Association (AMA) recently announced major revisions to Evaluation and Management (E&M) Services, effective Jan. 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, […]
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E-M Codes and Guidelines in 2023

Updates to the E&M Codes and Guidelines in 2023

The E&M categories that will undergo revision in 2023 encompass: ● Inpatient and observation care services. ● Consultations – both outpatient and inpatient ● Emergency department services ● Nursing facility services ● Home and residence services ● Prolonged services Throughout the upcoming months, a dedicated focus will be placed on each E&M category, delving into […]
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Medical/Legal Impact of 2021 E&M Changes

Without detailed documentation, providers may face an uphill battle in defending themselves from quality audits and even malpractice issues. Up until 2021, at least for the prior two decades, coders and clinicians relied upon the established Evaluation and Management (E&M) guidelines to determine which E&M code was appropriate for each specific encounter. The 1995 guidelines […]
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2021 AMA E&M Changes: A Provocative Overview

Many of us have been immersed in COVID-19 and telehealth billing, coding, and the varying rules among payors of late, all the while the clock has remained ticking on the looming changes to evaluation and management (E&M) services, effective Jan. 1, 2021. It is possible, too, that there are those who have not heard of […]
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