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E/M Coding Guidelines

  1. Default E/M Coding Guidelines
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    Hi guys!!!

    Hope everyone has a great Thanksgiving!!!

    Does anyone have any info relative to E/M coding. All my stuff is old and besides I thought we were past the whole idea of billing fours and fives for every visit.


    The docs went to a meeting and of course they were told since they are ortho specialists they can bill fours and fives. I gringe at the thought when I see dictations that say refer to medical history, discussed options, etc. Of course there is no written explanation of what was discussed. The complexity of diagnosis is also an issue. Not sure you can bill a four for a meniscal tear when the HPI is 3 sentences, physical exam is way less than 10 systems and the treatment plan is "treatment options discussed".


    Would appreciate some help. Even if there was some guide to purchase I would be interested.

    Thanks so much!!!

    Denise

  2. #2
    Location
    Columbia, MO
    Posts
    12,561
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    Quote Originally Posted by Desperate Denise View Post
    Hi guys!!!

    Hope everyone has a great Thanksgiving!!!

    Does anyone have any info relative to E/M coding. All my stuff is old and besides I thought we were past the whole idea of billing fours and fives for every visit.


    The docs went to a meeting and of course they were told since they are ortho specialists they can bill fours and fives. I gringe at the thought when I see dictations that say refer to medical history, discussed options, etc. Of course there is no written explanation of what was discussed. The complexity of diagnosis is also an issue. Not sure you can bill a four for a meniscal tear when the HPI is 3 sentences, physical exam is way less than6 10 systems and the treatment plan is "treatment options discussed".


    Would appreciate some help. Even if there was some guide to purchase I would be interested.

    Thanks so much!!!

    Denise
    Print the 95 or 97 guidelines they have documentation guidelines that make it easier written within the guidelines

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Nashville, Tennessee
    Posts
    35
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    Good morning Denise.
    Debra recommends the definitive guidelines, which must be followed. Read it and keep it close to you. However, I have several tools you can choose from that I'm quite sure will help you, but which must be used in conjunction with Medicare's official guidelines. Let me get to work and I'll send them to you.

    Sandy
    Sandy Stevens, CPC, CPMA

  4. Default EM Guidelines
    Thank you so much Sandy !!!

    I really appreciate the help!! I need to simplify it for them otherwise they will not read just the guidelines.

    Looking forward to hearing more.

    Happy Thanksgiving!!

    Denise

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