E/m Guidlines 95 Or 97


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I work for family practice and doctor's use encounter forms and I post them and I also have to read dictation to code e/m levels and dx and other cpt codes. I need to get experienced on how to use the e/m levels and I want to know how can I get copies of guidlines and how will I know what guidlines our doctors are using? Please Help! I am new at this.

Thank you in advance

Milwaukee WI
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1997 or 1995 guidelines

You can use EITHER the 1995 or the 1997 guidelines on any one encounter; but you can't mix the two within one encounter.

So for last week's visit you might use 1995 guidelines.
But for this week's visit you might use 1997 guidelines.
You can even switch within a day - patient A coded under 1995 guidelines; patient B coded with 1997 guidelines.
But you CANNOT use 1995 guidelines for the exam, and 1997 guidelines for the history and MDM of one visit's documentation.

Ask your office manager, or the physicians if there is an office protocol in place requiring that you use one set of guidelines specifically. That's the best way to know for sure.

You can google "1997 E/M guidelines" and you'll get tons of hits. Look them over and use the audit tool that seems to make the most sense for you.

Good luck. This is a great forum for asking questions if you get stuck.

F Tessa Bartels, CPC, CPC-E/M