Evaluation and Management Calculator

SUMMARY:

The E&M Calculator recommends CPT codes for E&M billing to providers who code during an exam. Now, when billing by time as provided by CMS guidelines that take effect in 2021, exam time is now computed (summed), instead of selected manually.

 

FEATURES:

1. E&M time calculations for the 2021 calendar year and beyond code New Patients and Established Patients using the following time ranges as defined by CMS

   1. NEW PATIENTS

      99201 Code deleted for 2021

      99202 15-29 minutes

      99203 30-44 minutes

      99204 45-59 minutes

      99205 60-74 minutes

      ESTABLISHED PATIENTS

      99211 No defined time range (less than 10 minutes)

      99212 10-19 minutes

      99213 20-29 minutes

      99214 30-39 Minutes

      99215 40-54 Minutes

2. Click the check box for time-based coding "Recommend CPT based on time only:" to code by exam time.

 

 

USAGE:

As a provider, I can select my E&M CPT based on total exam time instead of the complexity of the exam.

 

SCREENSHOT:

 

SETUP:

 

1. Configure the Exam Types used by the calculator in the new "Exam Types" Table Set, found in the Preferences menu.
2. Users can add more than one Exam Type to the "Exam Types" section in Table Sets.

 

NOTES:

 

1. For the defined values in Table Sets, total time is calculated (summed) and the appropriate CPT code from the above time range list is suggested.
2. Consult codes (no longer billable) and inpatient codes are not impacted and behavior remains the same.
3. Previous billing behavior to add charges remains the same.