Portfolio Project em overview w2

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Bryant & Stratton College *

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INTRO TO H

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Health Science

Date

Apr 3, 2024

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docx

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2

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Portfolio Project: E/M Overview W2    As part of our commitment to maintaining high standards of healthcare delivery, it’s essential for all staff members, especially front-end staff, to be proficient in Evaluation and Management (E/M) coding. This document aims to provide comprehensive training on E/M coding, including definitions, guidelines, punctuation abbreviations, CPT symbols, distinctions between new and established patients, place of service, and types of services.  Evaluation and Management (E/M) coding is a vital component of healthcare billing and reimbursement. It categorizes patient encounters based on the complexity of the services provided, including history taking, examination, medical decision making, counseling, coordination of care, and time spent with the patient. E.M codes are used to accurately document and bill for these encounters, ensuring proper reimbursement and compliance with coding guidelines.   Understanding E/M punctuation abbreviations is crucial for accurate coding. Some common punctuation marks used in E/M coding include:   Modifer-25: Indicates a significant, separately identifiable E/M service performed on the same day as a procedure.  Modifer-57: Indicates a decision for surgery, which may result in the immediate performance of major surgery.  CPT (Current Procedural Terminology) symbols are used to denote new codes and add-on codes. It is important to be familiar with these symbols to accurately assign codes. New codes are identified by a solid bullet (.), while add-on codes are indicated by a plus sign (+).  New patients are those who have not received any professional services from the physician or qualified healthcare provider (QHP) of the same specialty within the past three years. Places of service refers to the location where the healthcare service was provided, such as an office, hospital, or nursing facility. Understanding the place of service is essential for accurate coding and billing. Types of services encompass various levels of complexity and care settings, ranging from routine office visits to critical care services provided in an emergency department or intensive care unit.  Proficiency in E/M coding is fundamental or accurate documentation, billing, and reimbursement in healthcare settings. Front-end staff play a crucial role in ensuring compliance with coding guidelines and maintaining the organization's financial integrity. By understanding E/M coding principles, punctuation abbreviations, CPT symbols, distinctions between new and established patients, and place of service and types of services, front-end staff can contribute to the overall efficiency and effectiveness of healthcare delivery.    References: 
https://www.aapc.com/resources/what-are-e-m-codes   https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/ mlnproducts/downloads/eval-mgmt-serv-guide-icn006764.pdf      
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