AMA CPT® Assistant - 2007 Issue 7 (July)
Evaluation and Management Services Guidelines - What's New in CPT 2007? (July 2007)
July 2007 pages 1-4 Evaluation and Management Services Guidelines - What's New in CPT 2007? The Evaluation and Management (E/M) section contains the most widely reported codes of the entire CPT code set and offers a comprehensive set of codes for physicians to report their nonprocedural encounters with patients. The E/M section not only encompasses codes that are unique to the site of service, age, and body weight of patients (neonatal and pediatric codes) but also offers coding options that distinguish between new and established patients. Regardless of the specialty, the E/M section provides a means to report provider...
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Article Overview
This July 2007 CPT Assistant article reviews changes to the Evaluation and Management section of CPT 2007. It is relevant to physicians, coders, and billing staff who report nonprocedural E/M services across office, hospital, outpatient, nursing facility, home, transport, critical care, and case management settings. The article discusses updated guidance for consultations, inpatient and outpatient service reporting, pediatric critical care transport, ventilator management, neonatal and pediatric critical care, anticoagulant management, and the CPT explanation of testing, results, and reports.
Why This Topic Matters
The article helps readers understand how CPT 2007 revised E/M guidance affects service reporting across several common care settings and specialized situations. It is useful for identifying the scope of the changes and the code families affected by the update.
Article Sections
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Consultants
Overview of consultation policy updates in CPT 2007, including who may request a consultation and the general settings affected by the revised guidance.
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Office or Other Outpatient Consultations: New or Established Patient
Discussion of revised outpatient consultation guidance for office and other ambulatory settings, including follow-up visits and related established-patient reporting contexts.
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Inpatient Consultations: New or Established Patient
Summary of expanded inpatient consultation language for hospital, partial hospital, and nursing facility settings, along with related subsequent-care reporting context.
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Pediatric Critical Care Patient Transport
Review of updated guidance for pediatric critical care transport services, including bundled services and changes to the ventilator management code family.
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Critical Care Services
Overview of critical care reporting guidance for critically ill or injured patients and the services referenced as part of this E/M update.
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Inpatient Neonatal and Pediatric Critical Care Services
Discussion of inpatient neonatal and pediatric critical care reporting and the bundled service categories referenced in the revised guidance.
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Case Management Services: Anticoagulant Management
Introduction of a new case management subcategory related to outpatient anticoagulant therapy management in the E/M section.
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Results, Testing, Reports
Clarification of how CPT 2007 distinguishes between testing, results, interpretation, and reports in the codebook language.
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Endnote
Closing note identifying a transport-guideline reference issue for one code and indicating that the topic will be addressed in a later CPT cycle.
What You Will Learn
- Which E/M topic areas were updated in CPT 2007
- How consultation guidance was broadened at a high level
- What settings are addressed by the updated outpatient and inpatient E/M guidance
- Which specialized service areas were revised within transport and critical care policy
- How CPT 2007 framed the relationship among testing, results, interpretation, and reports
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians
- Practice managers
Codes Discussed
Code Ranges Discussed
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