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Billing Requirements for E&M Services in 2023


Learn the latest details on proper billing for Evaluation and Management (E/M) services in 2023. The new year will bring additional changes to E/M coding and leveling methodologies impacting inpatient services, observation, consultations, emergency department, home and residential visits, and skilled nursing facilities. New guidelines mean new clinical documentation requirements which will require you to modify how you code for a variety of services. Changes include deleting hospital observation codes and removing “domiciliary” or “rest home” as a setting for home care and descriptor changes related to new and established patients and initial and subsequent visits.

Take this opportunity to become informed of the new documentation guidelines. Don't risk payment delays, claim denials, and non-compliance. E/M services continue to be the most highly reported of provider services and a focus of payer audits. Scrutiny from the OIG, government-contracted, and third-party auditors make it especially important to keep E/M coding skills up-to-date and reduce the risk of accusations of fraud.

This information-rich session will help you keep your practice on track and financially viable. Receive expert guidance on best practices for E/M coding and billing. Gain details that will be vital to clean claims submission and timely payment in 2023. Clarification will be provided on when time-based coding is applicable vs. leveling based on medical-decision-making. Understand how to accurately report prolonged services. The instructor will outline the new clinical documentation requirements and share tips for the proper application of the updated E/M guidelines and code changes.

Highlights

  • bill based on time or medical decision-making
  • appropriately use the prolonged service codes
  • review the documentation requirements
  • choose the correct level of service based on medical decision making or time
  • navigate changes to the key components of history and exam and how to apply these elements to the new guidelines
  • understand medical decision-making guidelines, and how to apply them to the correct code

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CEUs:

PMI 3