Evaluation and Management CPT Codes comprehensive nursing paper example

Evaluation and Management CPT Codes comprehensive nursing paper example

Physicians and other qualified healthcare professionals like PMHNPs use evaluation and management coding comprising CPT codes ranging from 99202 to 99499 to capture their services. Of note is that these medical codes apply to visits and services that providers use to evaluate and manage patient health (Carlo et al., 2020). Some of the E/M services include but are not limited to home services, office visits, and services covering preventive medicine. One should be aware that radiologic imaging and surgical services are outside of the CPT code set that deals with the E/M section. Modern healthcare practitioners should be conversant with E/M codes as Medicare, Medicaid, and other third-party payers of health insurance accept the said codes once they are submitted as requests for reimbursements of services rendered. (Evaluation and Management CPT Codes comprehensive nursing paper example)

Evaluation and Management CPT Codes comprehensive nursing paper example
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· 0800: Medication management for a 32 yo female with Schizophrenia, obesity, on oral contraceptives

99201- 99205 if a new patient or 99211- 99215 for an established patient on pharmacological management.(Evaluation and Management CPT Codes comprehensive nursing paper example)

· 0830: Established patient, hospital D/C follow-up for a 64 yo male with Major Depression with psychotic features, HTN, Type 2 DM, COPD

99212 to 99215 as this an established patient who presents for follow up major depression with psychotic features. Unlike the initial visit where history, examination, and medical decision making are necessary for documentation, the follow up medical management visits mandates that two of the three components have to meet the required level of complexity to support the selected code level. For hypertension, the codes are 99473 and 99474.E 11 for type 2 diabetes mellitus and J 44.9 for COPD unspecified.(Evaluation and Management CPT Codes comprehensive nursing paper example)

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· 0900: Medication management for a 44 yo female with Schizoaffective D/O Bipolar type, migraine HAs

F25.0 for schizoaffective disorder bipolar type and 99202 to 99205 if a new patient with migraines with the total time for outpatient E/M ranging between 15- 29 minutes to 60-74 minutes. The E/M code for migraine headaches could also be 99212 to 99215 if a patient has a total time of 10-19 minutes to 40-54 minutes. Non- face to face time on the date of service inclusive.(Evaluation and Management CPT Codes comprehensive nursing paper example)

· 0930: Medication management for a 23 yo male with Bipolar I D/O with psychotic features

F31.64 for bipolar 1 disorder where the current episode is mixed with mood-congruent or mood incongruent psychotic manifestations. 

1000: New patient, hospital D/C follow-up for 25 yo male with Schizoaffective D/O, paranoid with AVH, substance useF25.0 for schizoaffective disorder bipolar type and 99202 to 99205 as a new patient. Additionally, code R44.0 for paranoid with AVH and 99408 or 99409 for substance abuse.(Evaluation and Management CPT Codes comprehensive nursing paper example)

· 1100: Medication management for a 37 yo female with Panic Disorder, endometriosis

F 41.0 for panic disorder and N 80.9 for medication management of endometriosis.

· 1130: Medication management for a 16 yo male with ADHD, asthma

99201 for office or other outpatient visits if a new patient with self-limited or minor problem lasting not more than 10 minutes, 99202 if low to moderate severity, 99203 if moderate in severity, 99204 if moderate to high in severity and 99205 if high severity.99211 to 99215 if an established patient with time ranging from 5 minutes to 40 minutes depending on the severity of the problem.(Evaluation and Management CPT Codes comprehensive nursing paper example)

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It is essential to acknowledge that contemporary healthcare services providers must familiarize themselves with E/M codes as E/M services are high-volume services. Kumetz and Goodson (2013) posit that there is a need for accurate reporting since minor E/M coding mistakes can lead to serious compliance and payment issues should the errors occur on claims in large numbers.

Evaluation and Management CPT Codes comprehensive nursing paper example
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References

Carlo, A. D., Drake, L., Ratzliff, A. D., Chang, D., & Unützer, J. (2020). Sustaining the collaborative care model (CoCM): billing newly available CoCM CPT codes in an academic primary care system. Psychiatric Services71(9), 972-974.(Evaluation and Management CPT Codes comprehensive nursing paper example)

Kumetz, E. A., & Goodson, J. D. (2013). The undervaluation of evaluation and management professional services: the lasting impact of current procedural terminology code deficiencies on physician payment. Chest144(3), 740-745.(Evaluation and Management CPT Codes comprehensive nursing paper example)

National Center for Biotechnology Information (nih.gov)

Evaluation and Management CPT Codes comprehensive nursing paper example
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