AMA CPT® Assistant - 2023 Issue 9 (September)

Questions and Answers (September 2023)

September 2023 page 46 Questions and Answers Evaluation and Management (E/M): Office or Other Outpatient Services Question: How does the patient-management option of continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) affect the E/M risk level and overall level of medical decision making (MDM)? Because the provider must write a prescription for the device, would it fall under moderate risk, ie, similar to prescription drugs? Answer: The E/M risk is based on the judgement of the clinician performing the patient management option of CPAP or BiPAP. If the clinician is simply noting the use of CPAP...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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