Posts Tagged ‘E/M’
CPT 2023 Code Set Now Available, Includes 393 Editorial Changes
AMA released the 2023 CPT code set with 225 new codes, 75 deletions, and 93 revisions. Modifications to the E/M codes are part of the 393 editorial changes for 2023.
Read MoreMore Changes Ahead For E/M: Review 2023 E/M Codes & Guidelines Here
January 2021 brought significant changes to the Evaluation and Management (E/M) codes for Office and Other Outpatient Services. AMA released a detailed document describing the 2023 E/M changes that will take effect on January 1.
Read MoreCMS Guidelines for Telehealth Coding & Billing During PHE
The Centers for Medicare & Medicaid Services (CMS) has decided to update the CMS billing and coding guidelines for telehealth or in-home provider services due to the urgency of the current 2019-Novel Coronavirus (COVID-19) pandemic (CMS, 2020). CMS has broadened the scope for reimbursement for virtual check-ins and other digital communications with patients to safely and effectively respond to this Public Health Emergency (PHE). In the interim, telehealth services will not be limited by program restrictions put in place by Medicare (Federal Register, 2020). Evaluation and management (E/M) service codes cover these remote and communication technology-based services performed by a physician or non-physician practitioner (NPP).
Read MoreIncrease Revenue & Lower Compliance Risk With These 6 E/M Tips
Selecting the right E/M code can be tricky – and sometimes, costly – business. On the one hand, the coder does not want to choose a diagnosis that’s too high, which could potentially incur audits or claims denials. But, if the coder selects a code that’s too low, there’s a chance of losing revenue for his or her organization. According to Medical Economics, “payers and auditors use a quantitative scoring process that requires specific elements (i.e., history, exam, and medical decision-making [MDM] – or time spent counseling and coordinating care) for each E/M level” (2020).
Read More