Evaluation and Management Tools

Evaluation & Management Tools

1995 E&M Guidelines

1997 E& M Guidelines

CMS E/M Guidelines & Resources


CMS - Can NP/PA do IP consults (for new pts)?

-     MLM 4215
-     MLM 5221
-     Transmittal R999CP

E/M Audit Template - from the American Academy of Professional Coders (AAPC)

E/M Audit Template from TheCodingCenter.org

E/M Audit Tool from First Coast 2005 prior to the interactive format, but still valid; with special thanks to Jean Acevedo, LHRM, CPC, CHC

E/M Review Checklist and Score Sheet Tool from Palmetto Medicare Part B, Jurisdiction 11

E/M interactive worksheet from First Coast Options - Florida Medicare; this allows you to do E/M audits using 1995, 1997 or both sets simultaneously right online. Click accept.

E/M Services from First Coast Options - Florida Medicare; is the point of origin for the E/M Interactive Worksheet with additional information

E&M Components - An excellent E/M Guidelines comparison study between 1995 vs. 1997

E/M Documentation Template - and Guidelines from American College of Gynecology (ACOG)

E/M Score Sheet, 2006 - from HGSA with special thanks to Jean Acevedo, LHRM, CPC, CHC

E/M University - Dr. Peter Jensen's page educating people about E/M Coding with web conferences, training guides & forums, Free AAPC CEUs, more. Great site!

-     Medical Decision Calculator

Table of Risk for Medical Decision Making

RSS AAPC E/M Discussion Forum

  • Not sure if this is fraudulent billing or where to find documentation stating it is August 12, 2020
    Is it illegal for a non medical transportation provider to bill medicaid for services that they were reimbursed for under a grant program from a mental health facility? I know this is a moral question and easy to respond with our moralistic believes, I am needing to find something in writing that states that it […]
  • Finger Amputation August 12, 2020
    Dr. did a right small finger amputation and a amputation of left ring finger. I ran the code 26951 through claims scrubber and it says this code is only payble with 1 unit. I tried XS modifier and 50 modifier. What am I missing?
  • OB patient with Medicare as primary August 12, 2020
    Hello All, looking for some insight-- we're having difficulty getting our OB related claims to Medicare paid-- in particular our OB patient had a 59025. Medicare is denying. Is there something I'm missing or some place I can go to for specific answer to Medicare OB billing? You're insight and expertise is appreciated. TIA
  • Infratemporal space abscess? August 11, 2020
    I'm having a hard time settling on a code for this procedure. I&D of infratemporal space abscess via trans oral approach PT had dental extraction of right 2nd and 3rd molars. Later, presented to ED with facial swelling, CT showed abscess lateral to maxilla extending into infratemporal fossa. Incision was made through mucosa, and carried […]
  • Atrial lead replacement August 11, 2020
    I see 33224 is replacement of a ventricular lead but i am not able to find anything for a replacement of an atrial lead. Doctor replaced atrial lead for an existing generator (ICD) Is there somewhere im not looking or should know? Any help or info is greatly appreciated.
  • Documentation Guideline 93010 August 11, 2020
    Does anyone have a CMS link on how to properly document the EKG read to support billing 93010 I saw some tips that there needs to be 3 elements documented when billing Medicare but cant find it Thanks!
Do NOT follow this link or you will be banned from the site!