Wiki Determination of the level of the E/M code

[rogers__dan@hotmail.com]

I am having difficulties with the determination of the levels for the E/M codes. I was wondering if someone could help out. Such as when looking at a patient going into the ER, or a new patient or returning patient, how to you determine the difference between 99211 - 99215 or 99281 - 99285. Although I have been guessing on some of these for part of my training, guessing is only going to get me so far. I have tried to look in my books, but nothing sticks out to me what to look at. Is there some kind of chart? I know when working on the practicode it talks about looking at a 4x4 rule, well that was not taught in my program, if someone could explain that, maybe that would help. Or if you have other ideas please share.

 

[ellzeycoding]

Some resources from CMS

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/eval-mgmt-serv-guide-ICN006764.pdf

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNEdWebGuide/Downloads/97Docguidelines.pdf

and info here too..

https://www.emuniversity.com/