What is EM?

Evaluation and Management (E/M) is a process that doctors and healthcare providers use to figure out what's going on with a patient and how to help them feel better. It's like when you visit a doctor, and they ask you questions about how you're feeling, check your body, and decide what treatment or advice you need. The E/M process involves looking at your medical history, doing a physical exam, and making a plan to take care of your health. It's an important part of giving you the right care and making sure everything is documented properly for billing and records.

What is E/M codes? E/M codes are CPT® codes from the range 99202-99499 that represent services provided by a physician or other qualified healthcare professional. These codes apply to visits and services that involve evaluating and managing patient health.

Examples of E/M services include office visits, hospital visits, home services, and preventive medicine services. Codes for services like surgeries and radiologic imaging are found outside of the E/M section of the CPT® code set.

Who uses E/M codes? Medicare, Medicaid, and other third-party payers accept E/M codes on claims that physicians and other qualified healthcare professionals submit to request reimbursement for their professional services. E/M service codes may also be used to bill for outpatient facility services.

Importance of E/M coding: Even small E/M coding mistakes can cause major compliance and payment issues if the errors are repeated on a large number of claims. Therefore, those involved in the coding process need to stay up-to-date on E/M coding rules.