In CMS
Jul 14th, 2017
Among the many provisions detailed within the 2018 Physician Fee Schedule Proposed Rule, released July 13, the Centers for Medicare & Medicaid Services (CMS) acknowledges that the current evaluation and management documentation guidelines create an administrative burden and increased audit risk for providers: Stakeholders have long maintained that both the 1995 and 1997 guidelines are ...
In CMS
Dec 5th, 2016
Centers for Medicare & Medicaid Services (CMS) evaluation and management (E/M) Documentation Guidelines (DG) allow providers to use an extended history of present illness (HPI), as defined by the 1997 evaluation and management documentation guidelines (DG), with the remaining elements of the 1995 DG. This means that “the status of three or more chronic conditions” ...
In Billing
Feb 19th, 2016
When billing Medicare, a provider may use either the 1995 or 1997 Documentation Guidelines for Evaluation and Management Services to document their choice of evaluation and management (E/M) CPT or HCPCS Level II code. For services performed on or after September 10, 2013, however, physicians may use the 1997 documentation guidelines for an extended history of present illness ...
In Billing
Nov 12th, 2013
By Jim Strafford, CEDC, MCS-P The Center for Medicare & Medicaid Services (CMS) has proposed a landmark change to emergency department (ED) and Clinic Facility coding methodology. If enacted, the proposal would mark an end to “levels” coding in the ED and hospital clinics. In a letter dated July 18, CMS announced that, as part ...
Dec 1st, 2007
Additional Workup Planned vs. Additional Workup Performed By Monique Waterford, CPC, CCS-P For many years there has been controversy over the interpretation and application of the Centers for Medicare & Medicaid Services (CMS) Documentation Guidelines for Evaluation and Management (E/M) Services. The Marshfield Clinics audit tool and its many derivatives have served as aids to ...