E/M Coding Alert - 2008 Issue 9
PART B REVENUE BOOSTER: 3 FAQs Help You Get a Handle on Your E/M Claims
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Article Overview
This premium article is a short Q&A-style coding update focused on evaluation and management claims under Medicare Part B. It is aimed at coders, billers, and physician practices that want to check how common E/M scenarios are handled, including group-practice discharge billing, preventive medicine visits paired with office/outpatient E/M services, and hospice consultation-related claims. The article also references guidance from CPT Assistant and discusses documentation concepts relevant to these situations.
Why This Topic Matters
E/M claims are among the most frequently billed services to Medicare, so small misunderstandings can create claim errors. This article helps readers review practical billing questions that affect documentation, code selection, and claim reporting in routine outpatient and hospice-related workflows.
Article Sections
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What Happens When Attending Isn't Available?
Discusses a hospital discharge billing question within a group practice setting and the general circumstances surrounding who may perform the service.
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Should We Report Entire First Visit With New Patient Codes?
Covers a new-patient preventive medicine encounter that also includes an office or outpatient E/M service, along with related documentation and CPT Assistant guidance.
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How Do I Bill Hospice Consults?
Addresses hospice-related consultation billing and the documentation themes associated with consult reporting in that setting.
What You Will Learn
- How this article frames common E/M billing questions in Medicare Part B
- What issues arise when a discharge is performed by another physician in the same group
- How preventive medicine and office/outpatient E/M services are discussed for a new patient encounter
- What hospice-related consult billing topics are highlighted
- What documentation themes are emphasized for consult reporting
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Compliance staff
- E/M educators
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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