DecisionHealth, DecisionHealth - 2023 Issue 5 (May)
Look for these key variances between CPT, payer E/M policies
Keep one eye on your private payers’ policies for E/M and prolonged services, the other on your denials and make sure you have a firm understanding of the differences between the AMA’s CPT guidelines and CMS rules for the services. You can reduce denials and improper payments if you understand where AMA and Medicare don’t see eye-to-eye on E/M coding.
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