PMI Basics: Introduction to E/M Coding

There are many things that need to be considered in order to determine the appropriate Evaluation and Management (E/M) code to use. This program will walk you through the fundamental principles underlying all evaluation and management coding and outline the steps that relate accurate code selection to proper reimbursement. Learn to identify and discuss the components of an E/M service focusing on the three key components, define medical necessity and comprehend the general rules for documenting E/M services.

Participants will receive E/M coding grids to aid in accurate level-of-service selection. Learn how to identify the E/M category/subcategory, and determine the level of history, the extent of the exam performed and the complexity of the medical decision making. Learn when time is a factor in selecting the proper code. Gain insight into the major differences between the '95 and '97 documentation guidelines gain confidence for discussing the components of selecting the proper E/M code.

Program Highlights:

• Overview of the CMS Documentation Guidelines for E/M Services
• Identify abbreviations like CC, ROS, and HPI
• E/M coding grids to aid in accurate level of service selection
• Hands-on practice utilizing E/M audit tools

Who Should Attend?

• Novice outpatient coders
• Experienced coders seeking a refresher on E/M coding basics
• Compliance and clinical staff seeking a grasp of E/M coding fundamentals

Prerequisites

This is a basic-level course. Content assumes an awareness of the role of medical coding in relation to outpatient provider reimbursement.

What to Bring

A course manual will be provided. Students may bring a CPT code set manual (optional).