2023 Gastroenterology Reimbursement and Coding Update (On-Demand) | November 2022-E&M Examples for both Medical Decision Making and Time Driven Visits

Video Transcription

Video Summary

The video discusses various patient scenarios and uses them to illustrate how to determine the level of service for medical billing based on the new guidelines. The first scenario involves an established patient with irritable bowel syndrome (IBS) who is stable and continues their current medication. This is determined to be a level three visit. The second scenario involves another patient with IBS who also has increased stress factors and anxiety. The patient's medication is adjusted and a referral for counseling is made. This is determined to be a level four visit. The third scenario involves an undiagnosed problem with left side pain and a history of ulcers. Various tests are ordered and reviewed, resulting in a level four visit. The fourth scenario involves a new patient with persistent diarrhea for six months. The patient's history and risk factors are considered, resulting in a level four visit. The fifth scenario involves a new patient with symptoms of acid reflux. The visit involves a detailed history and examination, resulting in a level three visit. Finally, the video briefly discusses how time spent by clinical staff cannot be counted for the level of service billing. Overall, the video emphasizes the importance of documenting in detail and accurately assessing patient complexity and risk to determine the appropriate level of service for billing.

Asset Subtitle

Kristin Vaughn, CPC, QMC, QMGC, CPMA, ICDCT-CM

Keywords

patient scenarios

level of service

medical billing

new guidelines

established patient

irritable bowel syndrome