The support you need to ensure compliance with major changes
A whirlwind of change is coming to E&M services – the most commonly used codes in any physician practice are about to be turned inside out. Are you ready? Not only are the codes, guidelines and documentation requirements changing, but organizations will also be allowed to select the level of service based on time or medical decision making and, of course, the calculations for both will also be changing. To really keep things interesting: these changes will only impact office visits to start, meaning there will be two sets of guidelines being used – one for office visits and one for the hospital or other settings.
Coders, audit and compliance staff, physicians, clinic staff and others will find this to be an ideal how-to resource that’s time tested and industry trusted. Calm the confusion ahead of the curve and approach the changes with confidence.
Features and Benefits
A new chapter to prepare for the coming changes:
- Specifics on the new guidelines, the corresponding codes and how they will be changing, and the documentation requirements to support code selections
- Guidance on the add-on codes for prolonged services and additional resources and how they will be used
- Understanding the new calculations for time and medical decision making and how they impact level of service
- Clear comprehension on the impact of these changes and how to communicate with and educate providers
- Tips for updating electronic medical record (EMR) templates to support the new documentation requirements
Ensure compliance with the existing guidelines:
- Expanded information on telehealth and online services
- Step-by-step documentation guidelines — detailed information covering E&M services in all settings and situations, including emergency departments, observation care, inpatient and outpatient consultations, nursing facilities and care plan services
- Thorough explanations of E&M components (history, examination, medical decision-making and medical necessity) and official documentation guidelines, plus discussion of how to interpret and apply the guidelines; includes a detailed comparison of 1995 and 1997 guidelines
- Modifier discussion — how to appropriately append modifiers to services, with specific examples of the proper and improper use of modifier 25
Expert tools for practical application of E&M guidelines and code selection:
- At-a-glance resources to help streamline coding and documentation
- Tips for staying compliant and avoiding payment penalties and/or claim reviews
- Case studies to reinforce best practices for supporting E&M code assignments
- Documentation examples covering a variety of scenarios; includes customizable sample forms
- Tables breaking down all categories of E&M services and the requirements for each
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