Tag: Medical Decision Making

E/M coding tips

Top E/M Code Tips to Boost Revenue and Mitigate Compliance Risk

This post dives into the top E/M coding tips that will empower your team to accurately capture the level of service provided, optimize revenue, and navigate the intricate landscape of compliance with confidence. 1. Embrace the 2021/2023 E/M Guidelines for Office/Outpatient Visits (99202-99215): The significant changes introduced in 2021 and further refined in 2023 for […]
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Comparing 2023 CPT E_M with Documentation Guidelines

Comparing 2023 CPT® E/M with Documentation Guidelines

The 1995 and 1997 Documentation Guidelines and the 2023 CPT® E/M Services Guidelines are not drastically different when compared side by side. Some hospitals and coding and billing entities may believe that the new 2023 CPT® evaluation and management (E/M) services guidelines and code changes simplify the coding, billing, and auditing processes. However, it is […]
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New E/M Billing Guidelines for Unreimbursed Services

New E/M Billing Guidelines for Unreimbursed Services

Recent changes to evaluation and management (E/M) billing guidelines that allow physicians to bill for previously unreimbursed services are producing higher revenues for longer patient visits, according to results of a new study. The study in JAMA Network Open looks at the financial impact of CMS’s 2021 expansion of its time-based billing guidelines to include […]
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Newly Revised CPT E&M Guidelines: Physician Fee Schedule Proposed Rule

Newly Revised CPT E&M Guidelines: Physician Fee Schedule Proposed Rule

A major revision of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) Guidelines for Office and Outpatient Visits (O/O Visits), Split/Shared Visits, and Critical Care Time billing was implemented Jan. 1, 2021. You would think that all office-based providers would have been made aware of this and changed their documentation accordingly, but there is […]
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6 Questions Ensure E_M Compliance

6 Questions Ensure E/M Compliance

Examine the utilization of Master Data Management (MDM) for coding office visits in 2021 from an auditor’s standpoint. When educating healthcare practitioners on the 2021 documentation guidelines for office/outpatient evaluation and management (E/M) services (codes 99202–99215), it is advisable to adopt an auditor’s perspective. A comprehensive auditor’s toolkit comprises four essential components: diagnoses, data analysis, […]
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6 Big Changes Coming for Office-Visit Coding

6 Big Changes Coming for Office-Visit Coding

Physicians will soon start having an easier time — and perhaps get paid more money — when they code for evaluation and management (E/M) services, thanks to the American Medical Association (AMA). The first major changes to the definitions for E/M services will be in effect as of January 1, 2021, with all payers expected […]
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E/M Changes Take Effect January 2021

  Good news for physicians tired of counting bullet points to assign an evaluation and management (E/M) level for an outpatient office visit: Per new AMA guidelines, it’s going to be a whole lot simpler. As of January 1, 2021, physicians will select an E/M code based on total time spent on the date of […]
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