Select the ROS Calculation Method

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Select E&M Coding Guidelines

Open the Practice Configuration template. In the E&M Coding section, do one of the following: Click in the 2021 Coding Effective Date. Then, select either the 95 Coding Guidelines or 97 Coding Guidelines option to use for visit types unaffected by the 2021 Coding Guidelines or for encounters before the effective date. Select the 95 Coding Guidelines option, and then select the physical exam calculation method. For more information, refer to Physical Exam Calculation for 95 Coding Guidelines section. Select the 97 Coding Guidelines option (default). For more information, refer to Physical Exam Calculation for 97 Guidelines section. Parent topic: Best Practices for E&M Coding Calculations

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Review and Configure 95 Detailed Numeric Exam Coding Thresholds

Open the Practice Configuration template. In the E&M Coding section, select the 95 Coding Guidelines option. For the 95 PE Exam Calculation Method, select the Detailed Numeric option. 95 Details in E&M Coding section Click 95 Coding Thresholds. The 95 Detailed Exam Coding Thresholds section appears. 95 Detailed Exam Coding Thresholds Review the default number of documented elements. To change the coding thresholds, click to enter a new number for an item under Body Areas or Organ Systems. Parent topic: Detailed Numeric Exam Coding Thresholds for 95 Coding Guidelines

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Review of Systems (ROS) Calculation for E&M Coding

The ROS information factors into the calculations under the 95 or 97 Coding Guidelines. All ROS symptoms are shared fields from the Symptom Master template or Symptom Master2 template. These fields are shared with both the History of Present Illness and Review of Systems templates. By using a single shared table, you do not have to reenter symptoms on a Review of Systems template if they were documented on a History of Present Illness template. For example, if positive for “fever” has been entered on a History of Present Illness template, it has also been filled on the appropriate Review of Systems template and appears in the ROS data grid. You can copy the previous review of systems information to the current encounter, click ROS History. The Historical Information window opens, click Copy ROS & Close to copy previous review of systems information to the current encounter on the SOAP template. You can give the E&M coding credit for ROS to the symptom from a History of Present Illness

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Review and Configure the 95 Single-organ System Complete Exam Thresholds

Open the Practice Configuration template. In the E&M Coding section, select 95 Coding Guidelines. For the 95 PE Exam Calculation Method, select either the Detailed Numeric or Strict Numeric option. 95 Details in E&M Coding section Click the 95 Complete Exam link. The 95 Single System Complete Exam Thresholds section appears. 95 Single System Complete Exam Thresholds section Review the default number of documentation elements for each organ system. To change the coding thresholds, click to enter a new number for an item under Organ Systems. Parent topic: Single-organ System Exam Thresholds for 95 Coding Guidelines

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Mark the MDM Level as Not Required

If you are using the 95 or 97 Coding Guidelines, you can choose not to use the MDM level as one of the three components for the overall E&M level. You can mark the MDM level as not required on the Practice Configuration template. This option is not applicable to the 2021 Coding Guidelines. Open the Practice Configuration template and then scroll to the E&M Coding, Medical Decision Making section. Select the MDM not a required component check box. MDM not a required component check box in E&M, Medical Decision Making section Click Save and Close. Parent topic: Medical Decision Making

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Configure 95 Strict Numeric Exam Levels by Payer

When you select the Strict Numeric option for 95 Coding Guidelines, you can configure all exam levels for each payer on the 95 Exam Payer Configuration template. Note: Payer configurations on the 95 Exam Payer Configuration template supersede all other coding configurations. Open the Practice Configuration template. In the E&M Coding section, select the 95 Coding Guidelines option. For the 95 PE Exam Calculation Method, select the Strict Numeric option. The 95 Exam Payer Configuration link becomes active. Click 95 Exam Payer Configuration. The 95 Exam Payer Configuration template opens. 95 Exam Payer Configuration template To review the 95 Exam payer information, click the Information icon. In the Payer(s) Available section, select a payer and click the right arrow to move the payer to the Payer(s) Selected section. Enter the number for each Physical exam level in the fields for Body areas/organ systems. Note: The defaults are 1 as the lowest possible value and 12 as the highest possib

Select the ROS Calculation Method

Recommendations

Select E&M Coding Guidelines

Review and Configure 95 Detailed Numeric Exam Coding Thresholds

Review of Systems (ROS) Calculation for E&M Coding

Review and Configure the 95 Single-organ System Complete Exam Thresholds

Mark the MDM Level as Not Required

Configure 95 Strict Numeric Exam Levels by Payer

Select E&M Coding Guidelines

Review and Configure 95 Detailed Numeric Exam Coding Thresholds

Review of Systems (ROS) Calculation for E&M Coding

Review and Configure the 95 Single-organ System Complete Exam Thresholds

Mark the MDM Level as Not Required

Configure 95 Strict Numeric Exam Levels by Payer