Evaluation and Management Coding: Maximizing Reimbursement Claims – Jacqueline Bauer

Keywords List

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Summary

• Archive: Evaluation and Management (E&M) Coding is frequently one of the most challenging areas for medical coders, and at the same time are the most common codes used for services being billed.

• Discover how to correctly determine proper use of CPT® codes, whether to use 1995 or 1997 guidelines, and what to look for in the notes to ensure reimbursement.Explore advantages and disadvantages of allowing the EHR to choose codes for you.

• Identify correct definitions of CPT® terms used and review all parts of the E&M section of the CPT® book (be sure to have your own CPT® book!).

• Walk away with the confidence to correctly utilize E&M codes the first time to maximize reimbursement.Identify the difference between consultations and transfer of careDetermine proper service level based on key componentsApply critical care codes correctlyDevelop strong documentation that will back your billingReduce your risk of up coding/fraud/abuseDistinguish when to use 1995 vs 1997 guidelinesTerminologyNew patientEstablished patientOn call for another physicianConsultationTransfer of careOversight servicesAdditional important termsServicesLocationOutpatientOfficeHospital observationHospital inpatientTypeNew vs.

• established patientsLevelKey components to select service levelHistoryExaminationMedical decision makingModifiersCritical Care10 commandments of critical careDocumentation