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Category Archives: Evaluation & Management: 2021 & Beyond

Medical Necessity and 2021 E&M Guidelines

E/M Coding & Auditing, Evaluation & Management: 2021 & Beyond, Today's TakeBy NAMASApril 21, 2022

Most of you are familiar with the medical necessity of the E&M encounter prior to 2021 documentation guidelines. But how does that equate in 2021? Today, we’re going to talk about how to understand medical necessity and 2021 documentation guidelines in the auditing of your encounters. Let’s take a look at the medical decision making…

Risk of the Complications for Patient Management and Treatment for Provider Consults

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASApril 2, 2022

  April 4, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Today, I want to bring you a little educational tidbit on E&M documentation improvement and how to audit those challenging sections of E&M. We’re going to take a look at the third column of our MDM table, the Risk of Complications for…

The Value of E/M Benchmarking: 2021 Data Shows Higher Coding

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASMarch 11, 2022

  March 11, 2022 | By Grant Huang, CPMA, CPC For the first time since CMS and the AMA implemented their 2021 revisions to office/outpatient evaluation and management (E/M) guidelines, we now have data on how those revisions may have impacted actual E/M code selection by healthcare providers. Utilization of level 4 visits is up…

Auditing Time-Based E/Ms Under 2021 Guidelines

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASDecember 24, 2021

  December 24, 2021 | By Grant Huang, CPMA, CPC The 2021 E/M guidelines’ more permissive rules for time-based coding is a potential watershed moment for physicians who want to spend less of their time documenting E/M notes. But if we interpret these changes to mean that the longstanding concept of “medical necessity” can be…

In a pediatric office, when is a fever considered a systemic symptom?

E/M Coding & Auditing, Evaluation & Management: 2021 & BeyondBy NAMASOctober 12, 2021

  October 12, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT 2021 AMA guidance indicates that a general systemic symptom such as fever should not be considered a systemic system, but not all fevers fall in this category. The question typically posed is: what is the “magic” range that identifies it as no…

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