AMA CPT® Assistant - 1995 Issue 2 (Summer)
Special Evaluation and Management Services Added to CPT 1995 (Summer 1995)
Summer 1995 pages 14-15 Special Evaluation and Management Services Added to CPT 1995 A new series of codes, Basic Life and/or Disability Evaluation Services and Work Related or Medical Dis-ability Evaluation Services, was added to CPT in 1995. These codes were added to report specific services that occur when completing evaluations for life insur-ance and/or disability claims, as well as work related or other medical disability examinations. The life insurance industry estimates that about $5 billion is paid each year for medical examinations and evaluations performed on applicants for life insurance. In addition, the role of the independent medical...
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Article Overview
This Summer 1995 CPT Assistant article introduces a new group of evaluation and management services added to CPT 1995 for life insurance, disability, and work-related or medical disability examinations. It is relevant to coders, billing staff, physicians, and compliance readers who need a high-level understanding of the service categories, the settings and situations they address, and the related documentation and reporting considerations discussed in the article.
Why This Topic Matters
The article helps readers understand a specialized set of E/M services that are separate from routine office visits and are tied to insurance and disability evaluation scenarios. It also frames when related E/M services may be reported in the same encounter and highlights the kinds of documentation these services involve.
Article Sections
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Summer 1995 pages 14-15
Introductory article context and publication placement within CPT Assistant.
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Special Evaluation and Management Services Added to CPT 1995
Overview of the new evaluation and management service categories added in CPT 1995 and the general circumstances they address.
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Basic Life and/or Disability Evaluation Services
Discussion of the basic life and disability evaluation service category and the general elements associated with it.
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Work Related or Medical Disability Evaluation Services
Discussion of the work-related and medical disability evaluation service category and the general elements associated with it.
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For Example:
A general example illustrating how the special evaluation and management services are discussed in relation to other reporting considerations.
What You Will Learn
- The purpose of the CPT 1995 special evaluation and management service additions
- The broad differences between life/disability evaluations and work-related or medical disability evaluations
- How the article frames documentation and certificate-related components of these services
- The general relationship between these services and other evaluation and management encounters
- The type of reporting considerations discussed in the example material
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Physicians
- Compliance teams
- Practice managers
Codes Discussed
Modifiers Discussed
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