tci Medicare Compliance & Reimbursement - 2006 Issue 14

Billing: CMS Transmittal Clarifies Proper E/M Claims Filing

Warning: Providers may be making crucial mistakes in E/M billing.A recent transmittal from the Centers for Medicare & Medicaid Services lays out some important rules for new patient evaluation and management billing.In transmittal 731, CMS fine-tunes its definition of "new patient" for E/M coding. Experts say the policy hasn't really changed, but CMS is explaining it differently, which should make things clearer. Someone is a new patient if none of the office's physicians have seen her face-to-face in the past three years, according to the transmittal. So if one of the physicians interpreted a patient's test results...

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