tci E/M Coding Alert - 2014 Issue 1

Reader Question: Define 'Calendar Date' For Proper Billing

Question: The CPT® surgery guidelines state that the surgical package includes “one related E/M encounter on the date immediately prior to or on the date of procedure (including history and physical).” Our question relates to the term “date.” Some in our office think that the term means that the E/M must be the “calendar date” of or preceding the procedure to be bundled. Others in our office think that if there’s a related E/M on any day prior to the procedure (maybe earlier the same week) that it is bundled. Which is correct...

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