Understanding E/M: Coding veterans offer praise, express concern, about new split or shared guidelines

Why This Topic Matters

Changes to split or shared E/M guidance can affect documentation workflows, provider billing practices, and how organizations align CPT-based guidance with Medicare and payer-specific rules.

Article Sections

1. Substantive portion guideline is a best practice

   This section compares the revised CPT approach with Medicare’s existing framework and discusses the documentation focus of the update. It also places the discussion in the context of E/M policy and provider attribution.

2. Physician attestation may be an option

   This section discusses whether the revised guidance may support physician sign-off or attestation concepts. It also addresses how documentation responsibilities may be viewed under the updated framework.

3. Prepare for setting-based confusion

   This section highlights potential confusion between CPT guidance and Medicare’s setting-specific rules. It emphasizes the need to monitor payer policy differences and maintain awareness of how billing practices may vary by site of service.