E&M Medical Coding — How to Level E&M Code (Part 1) http://www.cco.us/ceu-em-on-demand-classes-yt
Laureen: How to Level an E&M Code:
Q: Would it be possible to briefly go over your E&M leveling tool? Where I work, the providers level the visits. I code all diagnosis codes and add the appropriate modifiers.
So I’m really weak on being able to level E&M.
A: I can’t promise the briefly part, but I will definitely share my technique for doing E&M leveling.
Basically, this is a system I teach, this is actually how I got in doing my “Review Blitz,” I started tutoring people that were struggling with E&M back in the day. I took my exam in 1999, the E&M questions on the board were like 25, now they’re 10. So a lot of people were failing the exam just because of the E&M, so I would do tutoring and then I came up with this system and it really worked and so many students were like, “I finally get E&M!” So, hopefully, you’ll get that “aha!” moment tonight. If not, we do have a three hour class on E&M that’s on “On Demand” and it’s this system that I go over in a little bit slower.
One of the first things that I would teach you to do, if you’re one of my students is to mark up your E&M section of your CPT manual. I’m a very visual learner, I need visual cues to help me; so, I did this to help myself.
So, the four possible letters that you would be writing next to your History Bullet is PEDC and the same for Exam, which stands for Problem Focused, Expanded Problem Focused, Detailed or Comprehensive. And then, SLMH for the Medical Decision Making, which stands for Straightforward, Low, Moderate, High. Then, the other notation that you want to make is whether or not the particular code is a “3 of 3” code or “2 of 3” code. I’m going to explain all this, so if you’re scratching your head, hang with me here.
My system, what I call it is “Locate your HEM and Time.” It’s the little rhyme that I teach my students and I actually tell them on their exam booklets or in real world, a scratch piece of paper, Post-It, or whatever, write this down: Locate ___ (with a line next to it), H, E, M all with their own line, which stands for History, Exam, and Medical Decision Making – which are the three key elements of E&M coding and then Time. Sometimes, Time can be the controlling factor, not the HEM (History, Exam, and Medical Decision Making). The “locate” of course is the category and sub-category of the E&M: Was it an office new patient? Was it a hospital ER? That sort of thing.
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