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BC Advantage - 2023 Issue 4

Facility Outpatient E/M Coding

Reporting outpatient E/M services in a facility setting is a little different than other outpatient services. It is important to follow payer guidance. Novitas has provided some guidance on which codes to report based on the type of service provided. They have an FAQ page that covers both emergency department (99281-99285, G0380-G0384) and clinic visits, which states the following:Hospital outpatient clinic visits for assessment and management are billed with G0463.For a list of condition codes, occurrence codes, occurrence span codes, value codes, revenue codes, and all other required data reported on the UB-04, please visit the NUBC...

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