Understanding E/M: Making sense of E/M services in a world without consult codes

Why This Topic Matters

The removal of consult codes created new workflow and payer-coordination questions for practices. Understanding the article helps billing teams recognize the general areas affected by the change and the kinds of administrative updates practices may need to consider.

Article Sections

1. Consult code changes and billing questions

   Introduces the shift away from consult code billing and frames the main questions practices raised about reporting E/M services under the new approach.

2. Introducing AI

   Discusses Medicare reporting for initial inpatient E/M services when more than one provider may see the patient on the same day. The section focuses on the CMS guidance and the modifier introduced for identifying the physician of record.

3. Medicare as a primary/secondary payer

   Covers payer-order scenarios involving Medicare and other insurers, including CMS commentary on how practices should think about claims submission and secondary payer follow-up.

4. Educate your physicians

   Summarizes operational and training considerations for practice workflows, encounter forms, and documentation processes in response to the coding changes.

5. Official resources

   Lists external CMS and educational resources referenced by the article for readers seeking additional background.