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Evaluation & Management Essentials

evaluation and management essentials cover
Updated for 2017, this essential book includes new chapters on chronic and transitional care management services, and modifier -25.

Price: $167.00



Keys to accurate charge capture and compliant billing.

Is your facility getting paid appropriately for evaluation and management services? Many physician practices struggle with E/M documentation guidelines, which are often vague, leading to penalties for overpayment, as well as auditor claim reviews. You need a comprehensive resource for clearly understanding and applying E/M documentation requirements.

What's in this essential guide?

  • Introduction:
  • Chapter 1: What is Documentation?
    • Official Principles of Documentation
    • Fraud and Abuse
    • Malpractice
    • Documentation Formats
    • Scribed Services
    • Signature Requirements
    • Evaluate Your Medical Records
  • Chapter 2: Documenting E&M Services
    • Step-by-Step Documentation
    • Components of E&M Services
    • The History (Including 1995 vs. 1997 Guidelines)
    • Shared/Split Care and Incident-to
    • Modifiers
    • Teaching Physician Services
    • Clarification of Teaching Physician Billing Guidelines
  • Chapter 3: The Complete Medical Record
    • Baseline Data
    • Recording Preventive Medicine Services
    • Initial Preventive Physical Exam (IPPE)
    • Tobacco Use Cessation Counseling
    • Annual Wellness Visit
    • Sample Health Risk Assessment
    • Preventive Medicine Services (99381-99397)
    • Breast And Pelvic Screenings (G0101)
    • Screening Hemoccults (G0107) and Screening Flexible Sigmoidoscopy (G0104)
    • Preventive Counseling/Risk-Factor Reduction
    • Documenting Tests, Services and Procedures
  • Chapter 4: Pediatric Medical Records
    • Baseline Data
    • Pediatric Preventive Screening
  • Chapter 5: Reviews and Appeals
  • Appendix 1: Official Principles of Documentation
  • Appendix 2: Comparison of the Guidelines
  • Appendix 3: Categories of E&M Services
  • Appendix 4: Sample Documentation for E&M Codes
  • Appendix 5: Sample Documentation Forms