tci Part B Insider - 2015 Issue 7

Part B Coding Coach: Know How to Mix HPI/Exam for E/M Calculations

Some payers now allow you to use crossover elements. Calculating the level of evaluation and management (E/M) service your physician provides can be a challenge because of all the components. Add in two sets of guidelines — the 1995 and 1997 guidelines — and the confusion mounts. When it comes to using a patient’s history of present illness (HPI), review of systems (ROS), and past medical, family, and social (PMFSH) histories to choose the historical component of the service, things have gotten easier. For some payers, you can now use the HPI criteria from either the 1995 or...

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