E/M Coding Could Be Heading for an Overhaul

E/M Coding Could Be Heading for an Overhaul

The Centers for Medicare and Medicaid Services says providers have been clamoring for an update of the 1995 and 1997 guidelines for evaluation-and-management (E/M) codes—and it may be ready to oblige them. If it goes forward, the plan would take years to implement and focus mainly on revising the history and physical exam portion of a patient encounter. The aim, according to CMS, would be to simplify and better align E/M coding and documentation, presuming …

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Determining New vs. Established Patients for E/M Coding

Q.We are in the process of adding urgent care services to our occupational medicine clinic. How do we determine when to use a new or established E/M code for the patients who are seen for urgent care services? A.I continue to receive questions regarding the “when to code new or established patient E&M codes” conundrum, so let’s try to simplify the issue. The official CPT definition of new patient is: A patient who has not …

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