How Do You Figure Evaluation & Management Codes For Medical Billing?
Evaluation and management codes (CPT codes 99201-99499) are the most commonly billed codes in medicine. These are the codes for every office visit/encounter a physician has with a patient. It is easy to upcode, that is, bill for a higher level of service than was performed. It is also common for insurance companies to question and try to downcode, or request to change the level of service on a bill. It is important to understand how the evaluation and management codes work so that you, who work in the billing office of the physician,can properly code the bill and work with insurance companies to get the bill paid appropriately. There are many types of evaluation and management services. The most common types are new patient, established patient, consultation, and emergency room visits. New patient services refer to when a patient has never been seen by the physician, hasn’t been seen in the last three years, or a new specialist in the same clinic has performed the procedure. Establishe
