Wiki E/M

[VanMetre6173]

When coding an E/M code for an established patient, does medical decision making have to be one of the 2 out of 3 key components? If so where can I find documentation of this ?

 

[dclark7]

You need to check with your insurance carriers. For instance, Anthem of Ct has stated in their policies that MDM must be one of the 2 components used when determining E/M level. I haven't seen any other carriers do this yet, but it's best to check with your specific ones.

 

[Lynda Wetter]

You need to check with your insurance carriers. For instance, Anthem of Ct has stated in their policies that MDM must be one of the 2 components used when determining E/M level. I haven't seen any other carriers do this yet, but it's best to check with your specific ones.

In checking with the carriers is this something that someone needs to call and do, or do most carriers publish this info on their site?

 

[mhstrauss]

In checking with the carriers is this something that someone needs to call and do, or do most carriers publish this info on their site?

They should all be able to provide this information in writing in some way; I would think you should be able to find it on their sites. Of note, I've never seen any carriers with this requirement.