Healthcare providers who know how to code can significantly increase reimbursement and reduce revenue problems associated with stressful audits. AMA (American Medical Association) has introduced a new set of revisions in E/M codes, bringing a significant restructuring. The E/M coding changes would be effective from January 1, 2023, and are expected to make coding simple for healthcare providers.
E/M codes (Evaluation and Management Codes) are used in general medical practices like office visits, hospital visits, home care services, or preventive medicine services by qualified healthcare professionals (QHPs) or physicians. This blog will discuss everything you need about E/M coding changes in 2023.
Evaluation and management codes known as E/M or E and M are Current Procedure Terminology (CPT) codes ranging from 99202 to 99499. These AMA codes are commonly used for general visits among emergency room physicians, family physicians, and specialty care practitioners. These codes are based on the services given to the patients. E/M codes are used in every stage of the patient journey, from the time they enter your practice to physical examination and all procedures or medical evolution you perform.
Knowing E/M codes and understanding their care setting and corresponding service type is vital to maintain practice productivity, efficiency, and financial health. E/M codes are not used for surgeries, diagnostic testing, or radiology. These codes apply to the providers that evaluate or manage the patients. Many services fall under these codes, for example, a patient visiting a provider for a general checkup. Here are the types of services that fall under E/M codes.
There are three components of E/M codes according to MCT (Medicine & Medicaid services) when choosing the right level of E/M services offered:
Apart from these, other factors determine the selection of E/M codes, like the time spent on giving a particular service to the healthcare provider.
E/M code updates affect the guidelines on how these codes can be used. The recent update released by AMA affects different types of healthcare providers. Here is the initial list of guidelines and codes that were deleted, revised, and retained.
E/M coding changes have been introduced to ease the lives of healthcare providers and free their administrative burden.
Plutus Health has a team of certified coders who are updated with the coding updates. We use the correct codes to get you paid what you deserve. Connect with Plutus Health’s coding experts to know more about the coding updates and steps you should follow to benefit from them.
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Balaji Ramani has more than 22 years of experience in Healthcare Revenue Cycle Management. Balaji has expertise in building, training, mentoring, and managing end-to-end healthcare RCM teams. He has experience using the Web for information sourcing, research & analyses to enable ‘patient and payer satisfaction’ in the healthcare space.
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