e&m coding

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    RN Counseling Contribution to Physician E&M Coding

    While doing E&M code audits we have came across the question that pertains to Registered Nurses (RNs). Specifically, do their counseling sessions contribute to the calculation or justification of the Physician's Evaluation and Management (E&M) code? We understand that RN counseling contributes...
  2. C

    Wiki RN Counseling Contribution to Physician E&M Coding

    I am seeking your expertise regarding a specific question within medical billing and coding for which we have not found a definitive answer. The question pertains to Registered Nurses (RNs). Specifically, do their counseling sessions contribute to the calculation or justification of the...
    • coding@pprm.org
    • Thread
    • e&m audits e&m coding registered nurse
    • Replies: 3
    • Forum: E/M
  3. A

    Wiki Chiropractic NP E&M coding

    I have been having denials on claims with both 99203 or 99202 and 98941. This is not always the case. When I get it sent for review as both procedures being separate and distinct procedures, I am 50% on my success rate at getting it paid. I often get referred back to NCCI. This is all I can...
    • AMYDAWN90
    • Thread
    • 98941 99202 99203 chiropractic e&m coding new patient e&m spinal manipulation
    • Replies: 1
    • Forum: Chiropractic
  4. E

    Wiki What is the MDM Table C (Risk of Complications and/or Morbidity or Mortality of Patient Management) Level for Omeprazole 40 MG?

    What is the MDM Table C (Risk of Complications and/or Morbidity or Mortality of Patient Management) Level for Omeprazole 40 MG?
  5. L

    Wiki E/M Observation Status question

    A physician was asked to consult on a MEDICARE patient that is in observation status. what category of E&M code would you use? **I am so confused on this one.??
  6. N

    Wiki E&M billing under an ASC setting

    Can an E/M be performed & billed under an ASC setting if provided the fact that there was no other procedures performed on a same day ? Any advise to this is highly appreciated.
  7. R

    Wiki Evaluation and Management - data count

    Will it be right to say this plan has moderate data for 3 tests not ordered but may have been suggested or possible considered for this type of problem addressed? Impression: Cough (primary encounter diagnosis) Plan: Mother declined any testing (strep/flu/covid) for pt Mother just restarted...
  8. S

    Wiki telephone evaluation (new patient) from Nurse Practitioner from cardiovascular / office visit from Surgeon on the same date

    I am wondering if I can have some insight on this question. The patient was seen in Cath Lab 2 days prior: Heart Cath A Nurse Practitioner does a telephone call for a New patient (reviewing history, checking all the labs, diagnostic imaging, provider notes and risk and benefits for...
    • SSweetland
    • Thread
    • cardiovascular e&m coding
    • Replies: 0
    • Forum: E/M
  9. K

    Wiki E&M Coding??

    E&M level decision making? I believe it is the Provider's responsibility to choose the level of E&M services he/she provided. Then it is the Coder who should review. We have some Providers that are saying it is the Coders who should choose the level. I am looking for supporting documentation to...
  10. K

    Wiki E&M level decision making?

    E&M level decision making? I believe it is the Provider's responsibility to choose the level of E&M services he/she provided. Then it is the Coder who should review. We have some Providers that are saying it is the Coders who should choose the level. I am looking for supporting documentation to...
  11. C

    Wiki 2021 MDM: Procedure Risk Factors

    What would you identify as a procedure risk factor? Is it the documented inherent risks of the procedure? Please provide supporting references if possible.
  12. R

    Wiki 2021 E&M Changes

    Does anyone have any good resources for physicians in order to educate them on the 2021 changes?
  13. K

    Wiki Multiple Nurse Providers

    Can someone please help me code this scenario: PHN sees a patient for a quick office visit (i.e. pregnancy test visit) worthy of a 99211. Patient's pregnancy test come back positive and requests for further guidance. NP comes in for a visit worthy of a 99213. Can I bill both 99211 and 99213...
  14. A

    Wiki Physician E&M service same day Facility Infusion

    I hope I can get someone to shed some light on this issue. physician E&M service and facility infusion on the same day- So in peds, often times, the physician ends up seeing the patient on the same day as infusion therapy that is billed by the facility. Since the clinic and infusion suite...
  15. T

    Wiki Nurse visits and UAs

    Our coding dept is being requested to bill out a UA with a 99211. I know as it is an E&M I can add a 25 modifier. I am having trouble with this because of the UA having its own CPT code and by my understanding of E&Ms you can only bill both if there is a separate reason for the E&M service. Is...
  16. M

    Wiki Surgical/E&M codes

    Is it ok to send both E/M and surgical service together if no separate identifiable non-surgical service is given at the time of service? Is it per payer contract, which can allows both together(E/M and Surgical codes) or E/M code can supersede Surgical code even though it is truly surgical...
  17. J

    Wiki E&M productivity benchmark

    Hello All, My employer is looking for a way to gauge our heatlhcare providers as it relates to how well thier doing or not doing in thier E&M coding. Dose anyone know of any industry standard or some type of E&M productivity benchmark?
  18. L

    Wiki E/M Dermatology 99212, 99213

    We have had some difference of opinon on how to bill out the E&M lately with new drs on staff vs drs that have been here for years. Generally patient comes in here for a Full Skin exam which may or may not result in some biopsies but mostly the only other things notes are SK's and maybe Acne or...
    • LBernat7
    • Thread
    • dermatology e&m e&m coding
    • Replies: 2
    • Forum: E/M
  19. N

    Wiki Can a Physician charge an E&M with an EMG?

    Any help with this question would be greatly appreciated. Reference materials are welcomed also, thank you!
  20. S

    Wiki E&M Coding for non coders presentation

    Does anyone have a basic 101 E&M coding for non coders presentation that you are willing to share?
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