decisionhealth Newsletters, Coder Pink Sheets - 2025 Issue 3 (March)
Doing the splits: MDM offers more flexibility for split/shared visits
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Article Overview
This article reviews a coding scenario involving a physician, a qualified NPP, and a facility-based encounter to explain how split/shared visit guidance and medical decisionmaking considerations interact. It is aimed at coders and revenue cycle professionals who need to understand the general scope of CMS and CPT guidance relevant to E/M services, without relying on the full premium discussion.
Why This Topic Matters
Understanding the boundaries of split/shared visit reporting and MDM-based documentation is important for accurate E/M coding in facility settings. The article helps readers determine whether a situation is relevant to their workflow and flags the governing guidance sources referenced in the discussion.
What You Will Learn
- How split/shared visit concepts relate to facility-based E/M services
- What role medical decisionmaking can play in reviewing work performed on other dates
- How CMS and CPT guidance are referenced in evaluating contributor work
- Why substantive portion considerations matter in split/shared visit scenarios
Who Should Read This
- Medical coders
- Outpatient coding professionals
- HIM professionals
- Revenue cycle staff
- Compliance staff
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