Chapter 3: Evaluation and Management (E/M) Codes

Question 1

E/M Codes describe visits in which health care provides?

Answer 1

Evaluate a patient’s health status and then. manage a treatment plan.

Question 2

Because all medical specialties report codes from the E/M section, and since these are the services that providers most frequently provide where are the CTP codes?

Answer 2

At the beginning of the CPT code book for convenience.

Question 3

What are the 4 categories the E/M section is divided into?

Answer 3

Office and Other Outpatient Visits, Emergency Department Visits, Inpatient Hospital Visits, Skilled Nursing Facility Visits and Consultations.

Question 4

If the E/M Codes have different levels of services related to the complexity of the provider’s evaluation, What does the provider must consider to assign the appropriate E/M Code?

Answer 4

History, Examination, Medical Decision Making and Time.

Question 5

Why does the Provider must consider History when assigning the appropriate E/M Code?

Answer 5

Because the history will include the chief complain such as present illnes, review of symptoms, past medical histories.

Question 6

Why does the Provider must consider Examination when assigning the appropriate E/M Code?

Answer 6

To make sure what the problem is, expanded problem forced, detailed and comprehensive.

Question 7

Why does the Provider must consider Medical Decision Making when assigning the appropriate E/M Code?

Answer 7

To establishing a diagnosis and determine the treatment options.

Question 8

Why does the Provider must consider Time when assigning the appropriate E/M Code?

Answer 8

To see the total of time the provider spends on the date of the encounter, face-to-face and non-face-to-face.