[Download Now] Evaluation & Management Coding: Maximizing Reimbursement Claims – Jacqueline Bauer

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One of the most challenging areas for medical coders is evaluation and management coding, and at the same time are the most common codes used for services being billed. Discover how to determine proper use of the codes, whether to use 1995 or 1997 guidelines, and what to look for in the notes to ensure reimbursement.

The advantages and disadvantages of allowing the EHR to choose codes for you to explore. Review all parts of the E&M section of the book and identify the correct definitions of the CPT® terms. To maximize reimbursement, use E&M codes the first time.

1. Identify the difference between consultations and transfer of care
2. Determine proper service level based on key components
3. Apply critical care codes correctly
4. Develop strong documentation that will back your billing
5. Reduce your risk of up coding/fraud/abuse
6. Distinguish when to use 1995 vs 1997 guidelines

It’s called the Terminology.

• New patient
• Established patient
• On call for another physician
• Consultation
• Transfer of care
• Oversight services
• Additional important terms

Services

• Location
  • Outpatient
  • Office
  • Hospital observation
  • Hospital inpatient
• Type
  • New vs. established patients
• Level
  • Key components to select service level
    • History
    • Examination
    • Medical decision making
• Modifiers

It’s critical care.

• 10 commandments of critical care

There is documentation.

Maximizing Reimbursement claims is an evaluation and management coding topic. Maximizing Reimbursement claims is an evaluation and management coding topic. Maximizing Reimbursement claims is an evaluation and management coding topic.