Evaluation and Management (E&M) 2023

Billing and documentation for inpatient, emergency room, consultations, nursing facility, and home services will change effective January 2023.  Details and education materials are available.

Review E&M 2021 Resources Here

Primary Care Billing and Coding Book

This book reviews basics of Billing & Coding for primary care providers.
- E&M Basics
- Coding for Procedures
- Diagnosis (ICD-10) Coding
- Overview of RVUs

Primary Care Billing & Coding Presentations:
Charging for What You Do
Understanding RVU's and Targets
E&M Basics
2021 E&M and ICD10 Updates - Risk Adjustment for Primary Care
Diagnosis Coding and Risk Adjustment for Primary Care

Billing, Coding, Documentation Webinars

A collection of webinar links with information for billing and coding in telehealth.

Upcoming Webinars:

5/09/23 12:00-1:00pm - Modifier -25
6/13/23 12:00-1:00pm - Prolonged Services Case Studies

Medicare and Annual Wellness Visits

Annual Wellness Visits (AWV) provide health risk screening, preventive care and wellness counseling.  Medicare covers these annually to assess health risks and complete preventive care like immunizations, counseling and cancer screening.

Annual Wellness Visit Job Aid

Team-based Wellness Visits
The ABCs of the Annual Wellness Visit
Review of Opioid Use during AWVs
 

RN-Performed Virtual Medicare Wellness Visit [RNP-MWV) - *JHCP ONLY WORKFLOWS*

RNP-MWV Provider Workflow
RNP-MWV Scheduling Workflow
RNP-MWV Visit Workflow
 

Do these wellness services help patients? There is evidence that annual wellness visits in older adults leads to better health outcomes, so we encourage annual health assessments and preventive care in all older adults regardless of insurance

Preventive Care in non-Medicare Patients: USFHP and most commercial plans also cover annual preventive care visits. Insured adults ?65 with another primary payer require different components of “preventive care” services compared to Medicare patients.  These preventive services are billed using 99397 (established patient) and 99387 (new patient).

Annual Wellness Visits > 65 vs. Whole Health Exams

Whole Health Assessments
The Whole Health Assessment (WHA), also known as Whole Health Exam (WHE), was developed to ensure annual management of chronic health problems and preventative care. The WHA is covered once per calendar year for patients with Medicare Advantage.

Whole Heath Assessment Epic Workflow
Post Visit WHA Completion Tips & Tricks
2019 Whole Health Assessment Paper Form

AWV Recorded Webinars:
New updates include changes to Medicare Wellness Visit / Annual Wellness Visit workflows and forms.  Click the links below to view our recorded webinars on the topic.

5.10.21 - The New Annual Wellness Visit
5.11.21 - Annual Wellness Updates for Clinical Support Staff

Tips & Tricks: MWV/AWV
Tips & Tricks: Medicare Wellness Visit Questionnaire 

Health Risk Assessment (HRA): an HRA form is available on paper in several languages.  Questions appear in the same order as in the Epic Smartset.  Giving patients the paper HRA while waiting for the provider can save time.  The HRA can also be sent to patients as a MyChart message to increase efficiency further.

English
English - Alternate (abnormals in red, not for patient use)

Spanish 
Simplified Chinese
Korean 
Arabic

Explanation of Benefits (EOB) Letter
English version
Spanish version

Other Links & Publications