Medical Coding

Showing Category: Medical Coding

E/M Hospital Medical Coding App Coming Soon!

Hospital E/M is coming soon to the iTunes Appstore. Hospital E/M is a medical coding app to help you accurately code for common hospital based E/M services like admissions, follow up visits, and hospital discharges.  Select the level of service with confidence with Hospital E/M. Included inpatient E/M services New […]

E & M Service Coding and Audit Worksheet

Clear, complete, and concise medical documentation is critical to providing patients with high quality and safe medical care. Medical documentation is also essential for accurate and timely payment for healthcare services. Qualifying for payment requires skillful application of the documentation guidelines for evaluation and management services published by the Center […]

Emergency Department Downcoding Rate

What is Downcoding? Downcoding occurs when an insurer decreases the E&M service level to a lower code, resulting in lower payment for the service delivered.  For example, submitting a charge for a level 5 emergency department visit (99285, the highest level) for “allergic rhinitis” is likely to be downcoded. What […]

The official 1995 E&M Guidelines from CMS

What are E&M Services? Not all medical services are covered under the 1995 E&M Guidelines. Surgeries, lab tests, preventative medicine, counseling, and imaging studies have separate documentation rules. What are the differences between the 1995 and 1997 E&M Guidelines? The 1995 E&M Guidelines issued by CMS were the first medical […]

Official Trailblazer E&M Audit Tool as a PDF

Medical Decision Making (MDM) with the Trailblazer E&M Audit Tool Quantifying medical decision making for E&M coding is only partly outlined in the 1997 Guidelines for E&M Services. The exact methods to quantify the number of diagnostic/treatment options and the data reviewed is not clearly defined in these Guidelines. To […]