AMA CPT® Assistant - 2006 Issue 8 (August)
Coding Clarification: Evaluation and Management (August 2006)
August 2006 page 11-end Evaluation and Management: Levels of E/M Services, 99201 The following clarification is provided in response to a previously published question and AMA comment that appeared in the February 2006 CPT Assistant (page 14). Question Of the six components of evaluation and management (E/M) services, which are considered contributory factors? AMA Comment From a CPT coding perspective, history, examination, and medical decision making are considered the key components in selecting a level of E/M services. Counseling, coordination of care, and nature of presenting problem are considered contributory factors in the majority of physician-patient encounters. It is...
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Article Overview
This article presents a brief coding clarification for evaluation and management services from CPT Assistant. It addresses how the service-level framework distinguishes key components from contributory factors and explains the general context of the AMA’s updated comment. It is aimed at coders, billing staff, auditors, and other professionals who work with E/M documentation and code selection.
Why This Topic Matters
E/M coding is highly dependent on understanding which elements drive code selection versus which elements support the encounter context. Clarifications like this help coding professionals align their review and documentation practices with published guidance.
Article Sections
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August 2006 page 11-end
A short publication note identifying the source location and the timeframe of the clarification.
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Evaluation and Management: Levels of E/M Services, 99201
A coding clarification discussing the E/M service-level framework, the role of AMA commentary, and the general categories of encounter elements referenced in the guidance.
What You Will Learn
- How the article frames the evaluation and management service-level discussion
- Which broad encounter elements are treated as key components versus contributory factors
- How the clarification fits into the CPT Assistant context
- What types of E/M coding questions this guidance is intended to address
Who Should Read This
- Medical coders
- Coding auditors
- Billing professionals
- Physician practices
- Compliance staff
Codes Discussed
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