E&M: Key up the Focus to Complexity and Risk

E&M: Key up the Focus to Complexity and Risk

Recorded February 15, 2024

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Guest presenter Shannon O. DeConda, CPC, CEMC, CEMA, CPMA, CRTT.

She joins us for this look at complexity and risk when coding E/M services. Shannon is a partner at DoctorsManagement and president of NAMAS.

Prior to the new E&M guidelines, AMA CPT® did not reference medical necessity. The Claims Process Manual was our main point of reference for the statement Medical necessity is the overarching determining factor. While 2021 Documentation Guidelines uses 2 key components of time and MDM, the guidelines came armed with references of medical necessity littered throughout inferring that maybe it’s NOT always just 2 of the 3 key components. Let’s consider medical necessity.

After the webinar, participants will be able to:

• Define the financial loss of E/M Services
• Understand Medical necessity as the overarching determining factor
• Advise your physicians on complexity and risk

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