tci E/M Coding Alert - 2017 Issue 3

Reader Question: Choose 1995 VS. 1997 Guidelines Per Encounter

Question: I’ve heard that I can choose either the 1995 or the 1997 documentation guidelines for evaluation and management services. Is that true? How do I know which version to pick? Virginia Subscriber Answer: Yes. For many payers, including Medicare, when coding, you may choose either the 1995or1997 documentation guidelines to calculate the level of service for a patient encounter. You can switch between the different versions from encounter-to-encounter. Exception: In the past, you had to pick either the 1995 or 1997 guidelines and use your choice for the entire encounter. However, CMS changed its policy, so now...

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