E/M Office Visit Reference Guide, Fourth Edition

E/M Office Visit Reference Guide, Fourth Edition

The E/M Office Visit Reference Guide, Fourth Edition delivers a comprehensive overview of the E/M documentation guidelines and a clear, in-depth analysis of all updates and changes, including guidance on the medical decision-making (MDM) guidelines so that you can ensure accurate coding and billing.

Use the E/M Office Visit Reference Guide, Fourth Edition to train staff, reduce the risk of miscoding and the denials and audits that may result, and lessen the disruption to a key revenue stream. Given the amount of reimbursement dollars tied to the E/M codes, a lack of readiness could spell financial disaster. E/M office visits account for 20% of total physician fee schedule charges. In 2018, practices gained $15.6 billion in payments from Medicare for the suite of E/M office visit codes 99201-99215.

With the E/M Office Visit Reference Guide, Fourth Edition you can:

• Get a first look at the 2026 E/M fees.
• Take a deep dive into recent changes for facility-based coding.
• Ensure your coders are accurately selecting the correct level of service for E/M office visits with office and staff training tips, including separate breakout sections for coders and clinicians; audit safeguards; and more.
• Understand the level of medical decision-making or time for code selection with comprehensive coverage of MDM and time elements.
• Receive guidance from the AMA that you won’t find in your CPT® Manual.
• Get official CMS guidance on the E/M office visit documentation guidelines and detail the differences among regional Medicare administrative contractor (MAC) guidance.
• Take a look at how private payers are setting rules and releasing guidance.
• Review the "pain points" that are impacting practices and get solutions.
• Understand the differences between CPT® and HCPCS prolonged services coding.
• Train clinicians with several dozen documentation scenarios that clearly illustrate how a coder/clinician should accurately select a Level 1, 2, 3, 4 or 5 E/M code. The book will present scenarios tailored to specific specialties.
• Get vital FAQs based on upcoming updates and changes. The book's expanded FAQ section will answer confusing, hot-button items, such as the "data review" column of the MDM table.

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