CodingPregunta 13 de 100
Three key components historically used to determine the level of an evaluation and management (E/M) service are:
a.Diagnosis, procedure, and place of service
b.History, examination, and medical decision making
c.Modifier, units, and charge amount
d.Payer, plan type, and deductible status
Explicación
Traditional E/M level selection was based on the extent of the history, the examination, and the complexity of medical decision making. Contemporary office-visit guidelines allow the level to be chosen by medical decision making or by total time on the date of service. Accurate documentation of these elements supports the code selected.
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