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HCFA Acknowledges Need for Refinement of E&M GuidelinesRobert Berenson, M.D., HCFA’s Chief of the Center for Health Plans, was quoted in “Part B News” as acknowledging the need for further clarification of the Evaluation and Management (E&M) guidelines before one standard is mandated.
The issues questioned include:
Consistency in the application of the guidelines?
Would the guidelines be purposeful for medical care or only in the creation of additional paperwork?
Should the current definitions and the number of levels within some E&M categories be revised?
Are non-medically necessary services provided to achieve higher level codes?
These are important questions that remain to be answered prior to the release of the final version of E&M guidelines.
Currently either the 1995 or the 1997 E&M guidelines are acceptable forms of documentation. Please contact the OFBC with questions regarding E&M documentation standards.
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