Question

Read and assess the following documents as references and then write an essay evaluation of CPT Evaluation and Management Coding.   

"E.M Coding Article"

"Medicare Claims Processing Manual"
(Only read pages 39 to 91 of the Medicare Claims Processing Manual. Section 30.6 to 40 - Evaluation and Management Service Codes)

Be sure to cover the following points:
1. When and why CPT coding was developed, how it is maintained now and by whom.
2. What is the purpose of Evaluation and Management coding.
3. Using the purpose of Evaluation and Management coding as a guide, describe how that purpose is organized and used by the physician. Explain for what locations the codes are used and the importance of the documentation in the selection of the codes.
4. Explain the payment system used for physicians (briefly)

Solution Preview

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CPT coding was developed and introduced in 1992 to order and streamline the recording of the services provided to patients by different types of physicians. CPT coding replaced the old system when physicians were providing so called “visit codes.” The visit codes were too general, and they did not supply enough particulars to allow for a correct and accurate billing.

CPT codes are used by all health practitioners authorized by Medicare. This may include physicians and non-physician practitioners (NPP). In order to be considered for payment, the practitioners must be affiliated with Medicare. Any claims based on CPT codes coming from physical or occupational therapists in independent practice should not be paid....

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