Evaluation and management (E/M) services are cognitive (as opposed to procedural) services in which a physician or other qualified healthcare professional diagnoses and treats illness or injury. Nearly all physicians provide E/M services, however most services that infectious diseases physicians provide are of the E/M type. Appropriate documentation and coding of E/M services are vital to capturing the medical services provided to infectious diseases patients and therefore are also vital for appropriate reimbursement and compensation. IDSA has curated resources for ID physicians and their staff to assist in a better understand E/M coding.
Office/Outpatient Evaluation and Management Services Reference Guide and Clinical Examples
This reference guide, prepared specifically for infectious diseases physicians and their staff provides information and real-world clinical examples of how to select the most appropriate CPT code for office/outpatient visit encounters (codes 99202-99215). Definitions of the various elements of medical decision making and time along with other coding conventions are covered. The clinical examples follow a single patient case, from a minor problem with a low level of medical decision making (MDM) as it then progresses to the highest level of MDM, indicating the elements that led to the code that was chosen.
Frequently Asked Questions: Office/Outpatient E/M Services
IDSA has prepared an FAQ that answers questions and provides definitions for office/outpatient E/M Services. For other coding questions including CPT, HCPCS and ICD-10 codes, please submit a question via Ask the Coder.
For detailed information on the changes and instructions on how to use the revised E/M codes visit AMA CPT Information Office and Outpatient E/M.
Evaluation and Management Resources
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Home Infusion Therapy Services
- Medicare Learning Network article that provides guidance to providers and suppliers of home infusion therapy services about claims processing systems
Medicare Utilization Data for Infectious Diseases Physicians
Please visit the Medicare Research, Statistics, Data & Systems Page for free and purchasable information, including utilization rates, cost reports, error rates, and beneficiary and provider surveys.