Lesson Summary

In this video, the focus is on 99- codes, also known as evaluation and management (E/M) codes. Here are the key points covered:

• E/M codes are traditionally used for medical eye exams.
• These codes are not limited in how many times they can be billed.
• E/M codes are based on time or medical decision making (MDM).
• When it comes to time-based billing, only time spent by the physician on the date of the encounter is considered.
• Time spent does not include activities performed by staff or time used for separately billed services.

For time-based billing, there are certain time amounts required for different levels of codes. With MDM, coding is based on three criteria: problems, data, and risk (PDR):

• MDM requires meeting two of the three criteria (problems, data, or risk).
• PROBLEMS are defined as various matters addressed at the encounter.
• RISK refers to the probability or consequences of an event and is not quantified by CPT.

ODs on Finance has created a "cheat sheet" to simplify E/M coding based on time or MDM.

Resource: https://www.eyedock.com/coding-widget