Updating medical assistants cert

A substantive portion of an E/M visit involves at least one of the three key components (History, Examination, or Medical Decision Making).The physician and the qualified NPP must be in the same group practice or be employed by the same employer.The split/shared E/M visit applies only to select E/M visits and settings (i.e., hospital inpatient, hospital outpatient, hospital observation, emergency department, hospital discharge, office, non-facility clinic visits and prolonged visits associated with these E/M visit codes).

The National Correct Coding Initiative Policy Manual gives the following instruction: "Procedures should be reported with the most comprehensive CPT code that describes the services performed." The Current Procedural Terminology (CPT®) book has specific guidelines that give the following instruction: "Select thename of the procedure or service that accurately identifies the service performed." There are a wide variety of CPT and Healthcare Common Procedure Coding System (HCPCS) codes that specifically and accurately identify and describe the services and procedures performed by nonphysician health care professionals.

Can an evaluation and management (E/M) service be performed as a split/shared service?

Answer: A split/shared E/M visit is defined by Medicare Part B payment policy as a medically necessary encounter with a patient where the physician and a qualified non-physician practitioner (NPP) each personally perform a substantive portion of an E/M visit face-to-face with the same patient on the same date of service.

Note: This interactive worksheet was created as a tool to assist providers and is not intended as a replacement for the 19 E/M documentation guidelines published by the Centers for Medicare & Medicaid Services (CMS).

https://com/EM/165590Billing Guide CPT code 99499 Reporting CPT code 99499 (Unlisted evaluation and management service) should be limited to cases where there is no other specific E/M code payable by Medicare that describes that service.

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