2020 Evaluation and Management Coding Advisor

Optum360 | 2020 | Nichole VanHorn; Leanne Patterson

List Price

Item #: EMCA20
ISBN: 9781622546497
Available: NOW

Evaluation and Management (E/M) coding is notoriously difficult because coders have trouble selecting the correct code from among a range of seemingly appropriate choices.

Consequently, providers make more mistakes with E/M coding than coding for any other item or service. This new resource offers detailed and advanced guidance on selecting the appropriate E/M codes, with helpful resources designed for difficult E/M coding situations.
  • Optum360 Edge — Complete update to changes in E/M coding process. 
  • CY2020 PFS Final Rule guidelines included. Access CY2020 PFS Final Rule guidelines, along with the CY2021 changes to codes 99201-99215.
  • Compliance guidance, checklist, and worksheets help avoid costly revenue take-backs. 
  • ICD-10-CM code assignment hinges on the quality and detail of E/M encounter data. Get appropriate ICD-10-CM coding assignments with improved E/M coding process. Minimize physician queries and prevent delays in claims processing pending information and stop outright claims denials. 
  • Includes clinical case studies. Train coders and clinicians using real-life scenarios. 
  • Telemedicine services. Understand how E/M services are reported. 
  • Chapter addressing HCPCS codes. HCPCS types of services now in one chapter. 
  • Covers every E/M service. Review of the E/M rules and protocols. 
  • Helpful advice designed for difficult E/M coding situations. Well-patient exams, H1N1 flu, and other common, but problematic coding scenarios are explained. 
  • Includes Knowledge Assessments. With answers and rationale, get instant feedback on knowledge retention 
  • Targeted areas. Review what auditors are targeting, such as critical care. 
  • Documentation guidance. Review key factors for proper E/M code selection, plus advice to help clinicians make an objective review of subjective information.


Nichole VanHorn, CPC, CCS-P

Ms. VanHorn has more than 20 years of experience in the health care profession. Her areas of expertise include CPT® and ICD-10-CM coding in multiple specialties, auditing, and education. Most recently she served as Clinical Auditor for a multi-specialty group. Ms. VanHorn was responsible for the oversight of the physician coding and education section of the Corporate Compliance Program. She has been an active member of her local American Academy of Professional Coders (AAPC) chapter for several years and has also served as an officer.

CPT is a registered trademark of the American Medical Association.

Leanne Patterson, CPC

Ms. Patterson has more than 15 years of experience in the healthcare profession. She has an extensive background in professional component coding, with expertise in E/M coding and auditing, and HIPAA compliance. Her experience includes general surgery coding, serving as Director of Compliance, conducting chart-to-claim audits, and physician education. She has been responsible for coding and denial management in large multi-specialty physician practices, and most recently has been part of a team developing content for educational products related to ICD-10-CM. Ms. Patterson is credentialed by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC).