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Primary Care Coding Alert

E/M Coding:

Stymied by '95 or '97 Guidelines? How You Count Steers You Down the Right Path

Published on Mon Jul 02, 2012

Physical exam element can point you to the better set.Choosing whether to follow the 1995 or 1997 E/M coding guidelines can potentially boost your code level or prevent your physician for getting full credit for his work and reduce his legitimate reimbursement. If you sometimes wonder which set is better for your family physician's coding, focusing on how to tally your provider's physical exam documentation can be your key to success. Grasp "Drill Down" Versus "Holistic" Distinction Before jumping in too far, it's important to understand some basic differences between the guidelines. 1995: The 1995 guidelines are more physician-friendly and are less restrictive than the 1997 guidelines. They allow the physician to make any comment related to any organ system or body area he examines. Remember the physician gets the same amount of credit for examining a given organ system, no matter how much he or she does and documents [...]
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