What is a ‘new patient' and other E/M coding/billing tips revealed

Why This Topic Matters

Understanding the scope of this CMS guidance helps practices review office and facility E/M billing workflows, reduce claim errors, and support audit readiness.

Article Sections

1. CMS guidance update on common E/M questions

   Introduces a CMS resource guide and explains that it addresses frequently asked evaluation and management billing questions for Medicare claims. It also identifies the manual transmittal and change request referenced by the article.

2. New patient definition and same-day visit billing

   Summarizes Medicare guidance related to patient status and billing situations involving multiple office visits on the same day. The discussion includes general examples of related billing scenarios and documentation concerns.

3. Bundling of emergency department, office, and nursing facility assessments

   Covers guidance on how certain evaluation and management encounters are handled when they occur on the same day for the same patient. The section focuses on broad bundling considerations across settings.

4. Nurse visit billing and injections

   Addresses guidance related to nurse visits reported in connection with therapeutic or diagnostic injections. It also notes common audit issues described by the article.