Now I'm gonna go into the twenty twenty three. So in the twenty twenty three, it was our ability to expand the revised guidelines into all of the E/M code categories. So again, I'm going to pick my service. This time I'm going to do an emergency department service. In the emergency department, it is new or established. We don't have the distinction between a new or established patient. We use one set of code sets.

Now we are going to pick our data service and save that information. Now going through the medical decision making tool. Let's say that I have a patient come in, they're an asthmatic and they're having a severe exacerbation of their asthma. Let's say that they ran out of asthma medication, did not have an inhaler at home, now they're into a severe exacerbation and they're being seen in the emergency department.

With acute exacerbation of asthma, that would be a chronic illness because the patient has asthma, and it is a severe exacerbation because they do not have access to their medications.Now in the emergency department, they're going to be ordering most likely blood tests, okay? Let's say on this particular patient, they do order a comprehensive metabolic panel as well as a CBC. So they're gonna review and order it at the same date of service.

Now, with a patient that has a severe exacerbation, they may start with nebulizer treatments within the emergency department or administration of medication while they're in the emergency department in order to get this asthma under control.

So in this instance, it would be prescription drug management. If it's a severe exacerbation that they can treat in the ED and discharge the patient home, that's gonna be a lot different than a severe exacerbation that requires them to be admitted to the hospital for further treatment. But let's say for this particular patient, administration of medication gets their asthma under control.

The physician writes them a new script to get their asthma preventative medicines and rescue inhalers, and now the patient is discharged home. When I have those three elements together, it gives me a ninety nine thousand two hundred and eighty four, medical decision making of a moderate complexity.

So if I want to go back and let's do a different visit that's time based. Let's say that I'm doing a consultation and it is an outpatient office consultation. I'm going to save my data service to be the same. I'm going to go to my time-based codes. And it says time-based coding is allowed only if the criteria is selected as yes. Does the documentation reveal total time? If the answer is yes, then we're gonna say, okay, what was the total time? 25 minutes, and I'm gonna submit it.

The final code level based on time is 99242. So this is how you would utilize that particular tool.