Evaluation and Management (E/M) – Page 2

E&M Coding in 2021

Now is the time to take a few minutes to assess your coding.

If you are coding close to your specialty’s bell curve and if your documentation supports your coding, take a deep breath. If you find you are an outlier, don’t panic. Time is on your side.

Under-coders of the world, look to increase your coding. Your documentation likely supports a higher code. Over-coders, make sure your documentation supports your higher coding.

You are at higher risk for an audit, and your best defense will be solid documentation

Are you curious to see how you are doing? Follow this link to “Physicians Practice” article:

E&M Coding in 2021: Four Questions, Four Answers

6 Keys to Addressing Denials

6 keys to addressing denials in your medical practice’s revenue cycle

MGMA STAT – MARCH 18, 2021

The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Has your organization seen denials increase in 2021?”

69% said “yes.”
31% said “no.”

Common responses from respondents included payers not reimbursing for codes related to COVID-19 supplies, critical care claims and imaging CTs.

For those healthcare leaders who reported an increase in denials, the average increase in denials was 17%.

Half responded that they increased by 1% to 10%.
34% said 11% to 20%.
12% who stated 21% to 30%.

The poll was conducted March 16, 2021, with 576 applicable responses.

For great tips and strategies to use, follow this link or visit “The Business End” folder located in the InK files.

MGMA Community

This question was posed on the MGMA Community, March 2021.

Question: Posed from Community Member in Clearwater FL.

Would like to know how your offices are notating the total time on the date of patient visit for 99202-99215 OVs? Currently there is no statement from CMS re how the time must be documented other than total time is to be noted. We anticipate denials due to a lack of notation of time–is anyone seeing denials associated with this?

Reply #1: Community Member from Anchorage AK

Our provider’s note has the following statement at the end of each note:

I spent a total of 25 minutes on this appointment, including review of results, histories, x-rays, examination, consultation with the patient, and coordination of care.For office injections (which cannot be included in the total above if the patient came in for an office visit and the decision was made to also do an injection) we have this statement at the end of the procedure note:

I spent a total of 10 minutes prepping and performing the aspiration today, exclusive of and separate from the time spent on today’s appointment.

Reply #2: Community Member from New Jersey

We recommend to our clients that total minutes can be given, but giving the actual start & stop time is better. ” Pt. was seen for… from 9:01 – 9:22 for a total of 21 minutes.” Too many providers have total minutes that exceed 10-12-15 hours which is easy for auditors to see. That will keep providers out of trouble.