Category of Code Selection

March 17th, 2015 - Codapedia Editor
Categories:   CPT® Coding   Evaluation & Management (E/M)   Medicare  
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Does anyone remember the good old days, when you didn't need to know the patient's insurance to select a category of code?  Now, correct selection of an E/M category of code requires the clinician and coder to consider:

  • Where the service was performed
  • The status of the patient (Observation vs inpatient vs ED patient)
  • Whether the patient self referred, was sent for an opinion
  • Is new or estabilshed

This article has a one page pdf file attached to help with the decision making process.  For any insurances that follow Medicare rules on consults,  select the category of code as if they were Medicare patients when using this chart.

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