2025 Gastroenterology Reimbursement and Coding Update (On-demand)| November 2024-Overview of E&M Documentation Guidelines

Video Transcription

Video Summary

In this session, an overview of evaluation and management (E&M) documentation guidelines is provided, highlighting its importance for maximizing practice revenue. The discussion includes billing based on medical decision-making and social determinants of health, ICD-10 codes, and billing types. Trends in Medicare physician payments reveal a decrease in reimbursement despite rising operational costs. Changes made to reduce the administrative burden, such as modifications to history and physical exam documentation, are also discussed. Furthermore, the session delves into the specifics of coding by medical decision-making—focusing on problems addressed, data reviewed, and risk evaluation—and introduces pathways for billing by time. The necessity of accurate documentation to enhance medical decision-making and risk stratification processes is emphasized. The session concludes with the potential financial implications of improving E&M coding and documentation, projecting substantial revenue gains with even minor enhancements in billing practices.

Asset Subtitle

Edward Sun, MD, MBA, FASGE

Keywords

E&M documentation

medical decision-making

ICD-10 codes

Medicare payments

administrative burden

revenue gains