Wiki Physician E/M education


San Diego, CA
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I work for a GI in Central PA as office manager since Sept 2007. I am a CPC since 2004 and since I have been with the practice, I have been trying to educate the two doctors on how to code E/M services properly. They still get very defensive with me as to why they feel a particular level sholud be billed. This argument however does not show up in documentation. I fell the provider is getting irrated with me thinking I am impeeding his revenue by showing these changes. I moved here from Scottsdale AZ in 2005 and wil;l be moving back there in June and will be working for my former physician. In the meantime, I would like to help this doctor so he will not face and repercussions to his lack of coding knowledge. How do I get this taught w/o the Dr. getting defensive. These are rural doctors who are set in their ways (old School, if you will)
Thanks for your input....:

Kristin Felty, CPC
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I think the first thing I would do is look at 5 charts; and look at just the medical decision making-medical necessity portion. I would make sure that half meet the level coded and there is one example of each one above and one below.

So if the chart was coded a 99213; what level specifically did the MDM support. Have a few that does meet 99213 and have some that meet below and above.

Show the ones that meet; talking only about medical decision making then compare to one that did not meet and ask him questions such as why is this one a level 3 but when compared to the 'true' level 3 there are these differences.

Sorry this is hard to explain over email. But feel free to email me privately if you would like to talk more on this.