AHA Coding Clinic® for HCPCS - 2006 Issue 4

Hospital emergency department and clinic visits

Since April 2000, hospitals have been using CPT evaluation and management (E/M) codes to report facility resources for clinic and emergency department (ED) visits. Recognizing that the E/M descriptors were defined to reflect the activities of physicians and did not adequately describe the range and mix of services provided by hospitals, the Centers for Medicare & Medicaid Services (CMS) instructed hospitals to develop internal hospital guidelines to determine the level of clinic or ED services. For calendar year (CY) 2007, CMS requested comments on proposed national guidelines for the reporting of these codes. In addition, CMS had proposed HCPCS...

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