This on-demand course analyzes the CPT E/M guidelines that apply to office new and established patient visits, presenting them in a distilled, understandable way. Learn how to use the elements of Medical Decision Making and Time using example scenarios.
The American College of Surgeons designates this enduring activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Of the AMA PRA Category 1 Credits™ listed above, a maximum of 1 credit meet the requirements for Self-Assessment.
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- Identify the three elements of Medical Decision Making for Office and Other outpatient visit
- Evaluation and Management (E/M) codes.
- Describe when time can be used for code level selection
- Differentiate between types of problems addressed
- Understand how data reviewed and analyzed is counted
- Distinguish level of risk as it relates to code level selection
What's on the Agenda
Overview of Code Selection for Office/Outpatient codes 99202-99215
Using Time to Determine Level of Service in Outpatient Setting
- What is included in the new ranges?
What work and whose work is counted when time is used? Using prolonged service codes
Using Time to Determine Level in Outpatient Setting
Element #1: Number and Complexity of Problems Addressed
- Problems, Illnesses & Injuries: how are they defined?
- Stable vs chronic
- How is the complexity of the problem determined?
- Counting the number of problems. What constitutes a separate problem?
Element #2: Data to be Reviewed and Analyzed
- Defining Data Category 1
- What is included as an external note?
- What is a unique data test?
- What is a unique source?
- Who qualifies as an independent historian and how is this role documented?
- Defining Data Category 2
- Documenting independent interpretation
- Defining Data Category 3
- What constitutes a discussion of management or tests?
- Who qualifies as an external or other source?
Element #3: Risk of Complications and/or Morbidity or Mortality of Patient Management
- Defining level of risk: what does CPT say?
- Documenting level of risk. Do the current risk table examples still apply?
- How do test and treatment decisions impact co-morbidity and risk?