Reimbursement: Overlooking These E/M Tips Could Cost Your Practice $5000 Each Year

Why This Topic Matters

Small E/M services can add up over time, and incomplete or inaccurate documentation can lead to missed reimbursement or improper billing. Understanding the article’s guidance helps practices assess whether their records support the service level being reported and avoid common errors in routine staff encounters.

Article Sections

1. Check the Code Criteria

   This section reviews the basic reporting framework for a low-level office/outpatient evaluation and management service and the kinds of encounter characteristics that affect whether it may be reported. It also discusses patient status, provider involvement, and general documentation expectations.

2. Avoid Using 99211 in Some Circumstances

   This section covers common situations in which the service should not be reported separately and emphasizes the importance of documentation supporting medical necessity. It also addresses how record content can influence reimbursement and how the guidance applies in practice settings.