E/M Coding Revisions-E/M Coding Revisions Recording

Video Transcription

Video Summary

In the video, Dr. Alex Vaughan discusses the recent revisions to evaluation and management (E&M) coding guidelines implemented by CMS. He explains that the previous major revision to coding guidelines was in 1997, but the 2021 updates are a significant improvement. Dr. Vaughan emphasizes the importance of medical necessity in coding and advises practitioners to code based on either medical decision-making or time, whichever is higher. He provides detailed information on how to determine the level of medical decision-making based on the complexity of the problems, data review, and risk. He also explains the elements of time spent in face-to-face interaction with the patient and non-face-to-face activities such as reviewing tests or discussing management options. Dr. Vaughan recommends using a chart that outlines the time ranges for each code as a reference during billing. He also addresses the issue of insurance coverage and advises practitioners to check with individual insurance companies for their specific guidelines. Dr. Vaughan concludes by highlighting the importance of accurate documentation and the need to carefully navigate the gray areas of medical billing and coding. Overall, the video provides valuable insights and guidance regarding the recent E&M coding revisions and the principles of medical billing for practitioners.

Keywords

E&M coding guidelines

CMS

evaluation and management coding

medical necessity

medical decision-making

time-based coding

face-to-face interaction

non-face-to-face activities