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Leveling a Visit for an Acute Uncomplicated Illness
Manage episode 518896087 series 2490675
The September 2025 issue of CPT® Assistant raised important questions about how to appropriately level an evaluation and management (E/M) encounter when the presenting problem is an acute, uncomplicated illness or injury. A growing number of providers have been assigning Level 4 codes simply because an antibiotic was prescribed.
However, this approach may not be accurate when considering the full scope of the encounter and its required documentation elements.
Terry examines this trend and explains why many payers have responded by implementing automatic down-coding policies to address potential overcoding.
Subscribe and Listen
You can subscribe to our podcasts via:
- Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627
- Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX
- TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/
- YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg
- YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ
- Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874
- Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights
- iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/
The post Leveling a Visit for an Acute Uncomplicated Illness appeared first on Terry Fletcher Consulting, Inc..
96 Episoden
Manage episode 518896087 series 2490675
The September 2025 issue of CPT® Assistant raised important questions about how to appropriately level an evaluation and management (E/M) encounter when the presenting problem is an acute, uncomplicated illness or injury. A growing number of providers have been assigning Level 4 codes simply because an antibiotic was prescribed.
However, this approach may not be accurate when considering the full scope of the encounter and its required documentation elements.
Terry examines this trend and explains why many payers have responded by implementing automatic down-coding policies to address potential overcoding.
Subscribe and Listen
You can subscribe to our podcasts via:
- Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627
- Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX
- TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/
- YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg
- YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ
- Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874
- Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights
- iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/
The post Leveling a Visit for an Acute Uncomplicated Illness appeared first on Terry Fletcher Consulting, Inc..
96 Episoden
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