Defeat the challenges that threaten your E/M claims and compliance success. Evaluation and management (E/M) services are the lifeblood of your revenue stream, and yet they’re the most problematic to report. Claim denials remain high. E/M coding errors, in fact, rose from 11.9% in 2018 to account for 12.8% of CMS’s overall 2019 improper payment rate. How much E/M revenue are you losing? Safeguard your organization from claim denials and audit scrutiny with the Evaluation & Management Coding Reference Guide. Our experts break down E/M coding rules and requirements into simple, manageable steps written in everyday language to boost your E/M reporting skills. Learn how to capture the key components of medical history, physical exam, and medical decision-making—and capitalize on real-world clinical scenarios to prevent over- or under-coding. The Evaluation & Management Coding Reference Guide will help you prep for 2021 E/M guideline changes overhauling new and established office and outpatient services, and walk you through online digital E/M services, remote physiologic monitoring, and more. Master the ins and outs of E/M coding—CPT® guidelines, level of service, modifiers, regulations, and documentation guidelines. Put an end to avoidable denials and optimize your E/M claims for full and prompt reimbursement. Benefit from expert tutorials covering the spectrum of E/M reporting concepts and challenges: Prep for 2021 guideline changes and their impact on your organization Master the ins and outs of E/M guidelines in CPT® Capture the seven components of E/M services Sort out medical decision-making coding Avoid the pitfalls of time-based coding Nail down specifics for critical care E/M services Clear up modifier confusion Understand NPPs rules for same-day E/M services Take the guesswork out of complexity determinations Get the details on coding surgery and E/M together Learn the principles of E/M documentation

For introduction, reinforcement, or education of Evaluation and Management documentation requirements for a wide variety of clinicians in healthcare settings. Thorough and correct documentation of evaluation and management services provide the foundation for correct billing. Medical Coding Evaluation and Management, 1e provides an easy-to-read reference tool for thorough and effective documentation of any evaluation and management service visit. By focusing on the foundations of evaluation and management documentation guidelines, physicians, non-physician providers and other clinicians have the opportunity to understand the complexities of documenting any evaluation and management service correctly. Highlighting a variety of settings, readers learn about how to document medical history, physical examinations, medical decision-making, counseling and/or coordination of care, as well as intraservice time. Clinical examples, a clinical scenario and chapter exercises round out coding skills, as readers learn to dissect the evaluation and management visit and all its elements.

This guide explains the Evaluation and Management (E/M) coding process used by physicians and regulated by the American Medical Association. In four chapters, Dr. Christopher Taylor establishes a step-by-step approach to determining the correct CPT code for the most common patient encounters in the office, hospital, or nursing home. Helpful appendices provide E/M coding guide, templates, and additional information.

This easy-to-read text breaks these complex codes into manageable, bite-sized pieces. Practice questions and real-world case studies help you apply your knowledge and approach any coding situation with confidence.

Annotation Quick and easy tool for students and professionals. Whether studying for class or a coding certification test. Use as a quick go-to desk reference for the professional starting out or for the guru that has the ultimate coding toolbox of useful resources. 6-page laminated guide includes:Standard Steps & Codes for E/MDiagnosis or SymptomLocation of the ServiceRelationship Between Physician & PatientLevel of History from DocumentationLevel of Exam from DocumentationLevel of Medical Decision MakingChoose Code Based on Levels of Key ComponentsWhen Time Determines the E/M CodeModifiersSpecial Types of E/M ServicesHCPCS Level II E/M ServicesMedicare Documentation GuidelinesHistoryPhysical ExaminationMedical Decision MakingSuggested uses:Students - handy reference that is compact and easily reviewed on a daily basisCertification - great quick review tool for certification testingCoding Professionals - a quick reference memory refresherMedical Administration - training tool for coding or non-coding staff.

Master coding concepts related to medical necessity and report compliant codes for your services. Revenue loss, rework, payback demands—how much are medical necessity errors costing your practice? And that’s to say nothing of potential civil penalties. Get medical necessity wrong and it’s considered a “knowingly false” act punishable under the FCA. Stay liability-free and get reimbursed for your services with reliable medical necessity know-how. AAPC’s Coding for Medical Necessity Reference Guide provides you with step-by-step tutorials to remedy the range of documentation and coding issues at the crux of medical necessity claim errors. Learn how to integrate best practices within your clinical processes—including spot-checks and self-audits to identify problems. Benefit from real-world reporting examples, Q&A, and expert guidance across specialties to master coding for medical necessity. Learn how to lock in medical necessity and keep your practice safe and profitable: Avoid Medical Necessity Errors with CERT Smarts Rules to Improve Provider Documentation Denials? Pay Attention to Procedure/Diagnosis Linkage Nail Down the Ins and Outs of Time-based Coding Expert Guidance to Fend Off RAC Audits and Denials Beat E/M Coding Confusion with Payer Advice Improve Your ABN Know How with This FAQ

CPT® 2021 Professional Edition is the definitive AMA-authored resource to help health care professionals correctly report and bill medical procedures and services. Providers want accurate reimbursement. Payers want efficient claims processing. Since the CPT® code set is a dynamic, everchanging standard, an outdated codebook does not suffice. Correct reporting and billing of medical procedures and services begins with CPT® 2021 Professional Edition. Only the AMA, with the help of physicians and other experts in the health care community, creates and maintains the CPT code set. No other publisher can claim that. No other codebook can provide the official guidelines to code medical services and procedures properly. FEATURES AND BENEFITS The CPT® 2021 Professional Edition codebook covers hundreds of code, guideline and text changes and features: CPT® Changes, CPT® Assistant, and Clinical Examples in Radiology citations -- provides cross-referenced information in popular AMA resources that can enhance your understanding of the CPT code set E/M 2021 code changes - gives guidelines on the updated codes for office or other outpatient and prolonged services section incorporated A comprehensive index -- aids you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation to allow for a clearer, quicker search Anatomical and procedural illustrations -- help improve coding accuracy and understanding of the anatomy and procedures being discussed Coding tips throughout each section -- improve your understanding of the nuances of the code set Enhanced codebook table of contents -- allows users to perform a quick search of the codebook's entire content without being in a specific section Section-specific table of contents -- provides users with a tool to navigate more effectively through each section's codes Summary of additions, deletions and revisions -- provides a quick reference to 2020 changes without having to refer to previous editions Multiple appendices -- offer quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, vascular families, multianalyte assays and telemedicine services Comprehensive E/M code selection tables -- aid physicians and coders in assigning the most appropriate evaluation and management codes Adhesive section tabs -- allow you to flag those sections and pages most relevant to your work More full color procedural illustrations Notes pages at the end of every code set section and subsection

This book explores Evaluation and Management (E/M) coding and serves as a resource in the practice and application of level of service codes. For two decades the 1995 and 1997 guidelines have provided guidance and structure around the documentation requirements necessary to support professional, outpatient services. After twenty-three years, Medicare has announced the adoption of a new set of standards to be released on January 1, 2021. This book will serve as a guide for correct code assignment and as an educational resource for the 1995, 1997 and 2021 documentation guidelines.

This portable guide provides a solid foundation for the Current Procedural Terminology (CPT®) coding system and clarifies E&M coding. Easy-to-use tables help you avoid penalties and increase revenue.? The only book that combines E&M coding guidelines with more than 1,800 musculoskeletal CPT codes? Find Medicare Facility, Nonfacility, and Work RVUs, and Global Fee Periods

The newest edition of this best-selling educational resource contains the essential information needed to understand all sections of the CPT codebook but now boasts inclusion of multiple new chapters and a significant redesign. The ninth edition of Principles of CPT(R) Coding is now arranged into two parts: - CPT and HCPCS coding - An overview of documentation, insurance, and reimbursement principles Part 1 provides a comprehensive and in-depth guide for proper application of service and procedure codes and modifiers for which this book is known and trusted. A staple of each edition of this book, these revised chapters detail the latest updates and nuances particular to individual code sections and proper code selection. Part 2 consists of new chapters that explain the connection between and application of accurate coding, NCCI edits, and HIPAA regulations to documentation, payment, insurance, and fraud and abuse avoidance. The new full-color design offers readers of the illustrated ninth edition a more engaging and far better educational experience. Features and Benefits - New content! New chapters covering documentation, NCCI edits, HIPAA, payment, insurance, and fraud and abuse principles build the reader's awareness of these inter-related and interconnected concepts with coding. - New learning and design features -- Vocabulary terms highlighted within the text and defined within the margins that conveniently aid readers in strengthening their understanding of medical terminology -- "Advice/Alert Notes" that highlight important information, exceptions, salient advice, cautionary advice regarding CMS, NCCI edits, and/or payer practices -- Call outs to "Clinical Examples" that are reminiscent of what is found in the AMA publications CPT(R) Assistant, CPT(R) Changes, and CPT(R) Case Studies -- "Case Examples" peppered throughout the chapters that can lead to valuable class discussions and help build understanding of critical concepts -- Code call outs within the margins that detail a code description -- Full-color photos and illustrations that orient readers to the concepts being discussed -- Single-column layout for ease of reading and note-taking within the margins -- Exercises that are Internet-based or linked to use of the AMA CPT(R) QuickRef app that encourage active participation and develop coding skills -- Hands-on coding exercises that are based on real-life case studies