Overview
You can now more easily use the Evaluation and Management (E&M) Coder tool, which is accessible via the Billing Tab. The page has been improved to greatly reduce the number of clicks and eliminate unused fields from the outdated '95/'97 guidelines.
Additionally, the page now supports additional Places of Service for the associated service department. (Previously only some Office Places of Service were supported.) Currently, we support the following Places of Service:
Office (02, 03, 05, 06, 07, 08, 10, 11, 15, 17, 18, 19, 20, 22, 26, 49, 50, 71, 72)
Home, residence and domiciliary (04, 09, 12, 13, 14, 16, 33, 55)
Nursing (31, 32, 54, 56)
We intend to support additional Places of Service in a future update.
You can reference full guidelines for both Medical Decision Making (MDM) evaluation and time-based evaluation within the page. We're making this change so you can easily reference these guidelines, in particular the MDM levels.
We're making this change because you requested it. Keep those suggestions coming! For the original suggestion, please see the followings requests on Success Community.
Benefits
Save time and reduce clicks; in most cases, only 5 clicks should be necessary to add a code
Reference the 2021 guidelines as you use the E&M Coder
Additional Places of Service may properly use the E&M Coder
Display the E&M Coder
Display the E&M Coder section:
Providers
In the Sign-off stage of the encounter, click the Billing tab, then click E&M Coder.
Administrative staff
On the Claim: Billing tab in the Checkout stage, scroll down to the Services section to see confirmation of the E&M coder calculation.
Using the E&M Coder
The following image is an example of the E&M Coder tool with an additional image for the associated guidelines which always appear to the right of the tool itself.
To determine which code to use:
-
Choose a guideline.
Note
The 2021 - Medical Decision Making guideline is automatically selected. Click the patient status. If athenaOne can determine that the patient is established based on historical billing data, the Established option gets selected automatically.
- If you choose:
- 2021 - Medical Decision Making — Select the values of all three Medical Decision Making questions. For more information on each question, you may review the 2021 guidelines on the side. Clicking the downward arrow will expand the associated guidelines for each question.
Time-Based Billing — Enter the total amount of time you spent associated with that visit on the date of service.
Tip: Hover over the image for a closer look.
Once you enter all of the information, athenaOne automatically determines the associated code.
Click Apply Code. The window closes and athenaOne adds the code the Billing Tab automatically.
To make further adjustments, re-open the E&M Coder where you can see all of the selected values and update as needed.
For Nursing Places of Service, you'll see different fields reflecting the needs of the associated code evaluation:
2021 - Medical Decision Making
