Health Information Management

Pay-per-view: E/M reporting remains a challenge in the ED

APCs Insider, October 23, 2015

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Because CMS has not created any national ED E/M guidelines, providers must create their own criteria for each visit level. CMS has developed a list of 11 criteria that it uses when auditing facility E/M criteria.

Facility ED E/M guidelines should be designed to reasonably relate the intensity of hospital resources required to the different levels of effort represented by the code.

Note that ED E/M codes do not distinguish between new and established patients. Additionally, because E/M services in the ED vary so widely in intensity, time is not used as a descriptive component of the codes.

Continue reading "E/M reporting remains a challenge in the ED" on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the October issue.



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