There are many types and places of service found within this CPT section. As a coder, it is essential that you fully understand what services are captured including the many categories and sub-categories located in E/M. As a coder, you will be called upon by your providers and others based on your expertise in this area.
Demonstrate your understanding of the E/M section through participation in this discussion.
Include the following aspects in the discussion:
List one category or sub-category in Evaluation and Management
Provide at least three examples of codes and descriptions from the category or sub-category selected
Describe when it would be appropriate to use these services
Discuss if there may be a difference in reimbursement based on the examples you shared. Do not duplicate another peer’s category or sub-category, there are plenty of options for everyone
Sample Answer
Category in E/M: Preventive Medicine Services
This category is a great example of how E/M coding goes beyond just treating illness and focuses on maintaining wellness. These codes are used for a patient's routine annual physical or wellness exam.
Code Examples and Descriptions
99385: Initial preventive medicine evaluation and management of a new patient; 18 through 39 years. This code is used when a provider is performing a complete preventive medicine exam on a patient who has never been seen by them before or has not been seen for at least three years. The patient is in the young to middle-adult age range.
99393: Periodic preventive medicine reevaluation and management of an established patient; 18 through 39 years. This code is used for a patient who is already established with the provider and is returning for a routine annual physical. The patient is in the same age range as the previous example.
99396: Periodic preventive medicine reevaluation and management of an established patient; 40 through 64 years. This code is also for an established patient's routine annual physical, but the age range reflects a different stage of life where different types of screenings and counseling are typically performed.