Overview
Evaluation and management (E/M) services are cognitive (as opposed to procedural) services in which a physician or other qualified healthcare professional diagnoses and treats illness or injury. Nearly all physicians provide E/M services, however most services that infectious diseases physicians provide are of the E/M type. Appropriate documentation and coding of E/M services are vital to capturing the medical services provided to infectious diseases patients and therefore are also vital for appropriate reimbursement and compensation. IDSA has curated resources for ID physicians and their staff to assist in a better understand E/M coding.
Updated Evaluation and Management Services Reference Guide
Over the past years, the Centers for Medicare & Medicaid Services has made significant revisions to evaluation and management services, allowing physicians to select the E/M visit level to bill based on either total time spent on the date of patient encounter or the medical decision making used in the provision in the visit. In 2022, changes were established for the office and outpatient setting. In 2023, reforms extended across all health care settings including hospitals, emergency departments, nursing facilities and patients’ homes. 2024 brings an add on complexity code G2211 and split or shared visits. To learn more, check out IDSA’s 2024 Evaluation & Management Services Reference Guide, designed to educate ID physicians on these important changes. More resources and tools to come in 2024!
For additional resources, please check out the CMS E/M guide here, along with a Code G2211 Fact Sheet from CMS.
2023 E/M Inpatient Code Changes: IDSA Resource Guide
In this webinar, Drs. Amy Kressel, Ron Devine, and Timothy Sullivan of the IDSA Payment Policy Work Group go over the new 2023 E/M Inpatient Code changes. They cover definitions of the various elements of medical decision making (MDM) and walk through clinical examples that follow a single ID patient case, from a minor problem with a low level of MDM as it progresses to the highest level of MDM. This webinar references the IDSA E/M Resource Guide, which can be found here.
Frequently Asked Questions: IDSA Evaluation and Management CPT Coding Guide
IDSA has prepared an FAQ that answers questions around the new E/M code changes.
Evaluation and Management Resources
- Office/Outpatient Evaluation and Management Services Reference Guide
- Office/Outpatient E/M Services FAQs
- Office and Outpatient E/M Webinar
- CPT® Evaluation and Management
- Revisions to the CPT E/M Office Visits: New Ways to Report Using Time
- Revisions to the CPT E/M Office Visits: New Ways to Report Using Medical Decision Making (MDM)
- Implementing CPT Evaluation and Management Revisions
- Medicare Evaluation and Management Services Guide
Used with permission of the American Medical Association. AMA CPT Professional 2024, ©Copyright American Medical Association 2023. All rights reserved.