E/M Coding Guidelines Breakdown Exam
Questions| Already answered| GRADED
A+
New patients - ANSWER-Patients not seen by provider/practice in same specialty in past 3 years
Levels of service - ANSWER-Assigned based on medical decision-making or time
Medical decision making - ANSWER-Includes diagnosis/management options, data complexity, risk
assessment
E/M service limit - ANSWER-Typically one allowed per day per provider
Encounter elements - ANSWER-Include history, exam, counseling, ordering, documenting, interpreting
Medical decision making components - ANSWER-Problems addressed, data complexity, risk assessment
Modifier 24 - ANSWER-Unrelated E/M during postoperative period
Modifier 25 - ANSWER-Separately identifiable E/M service
Modifier 32 - ANSWER-Mandated services by third parties
Modifier 52 - ANSWER-Reduced services compared to standard E/M
Modifier 57 - ANSWER-E/M service to decide on surgery necessity
Questions| Already answered| GRADED
A+
New patients - ANSWER-Patients not seen by provider/practice in same specialty in past 3 years
Levels of service - ANSWER-Assigned based on medical decision-making or time
Medical decision making - ANSWER-Includes diagnosis/management options, data complexity, risk
assessment
E/M service limit - ANSWER-Typically one allowed per day per provider
Encounter elements - ANSWER-Include history, exam, counseling, ordering, documenting, interpreting
Medical decision making components - ANSWER-Problems addressed, data complexity, risk assessment
Modifier 24 - ANSWER-Unrelated E/M during postoperative period
Modifier 25 - ANSWER-Separately identifiable E/M service
Modifier 32 - ANSWER-Mandated services by third parties
Modifier 52 - ANSWER-Reduced services compared to standard E/M
Modifier 57 - ANSWER-E/M service to decide on surgery necessity
