Try this interactive worksheet from First Coast Service Options (FCSO) - the Medicare Administrative Contractor for A/B services for Florida. The worksheet is intended for physician training to improve correct coding of Evaluation and Management CPT codes.
I tried it.
Plug in your actions from your evaluation is the areas of History, Examination and Medical Decision Making and the Worksheet will spit out its best guess of which E/M code you should bill as if you were a physician.
The interesting thing is that my typical physical therapy evaluation corresponds to a Level 3 E/M codes (99203). Of course, physical therapists can't bill E/M codes because we are not physicians.
If you consider, however, the condition of our patients, the tests and measures physical therapists use, the complexity of our decisions and the risks we face I wonder if altering payment systems to allow PTs to bill E/M codes for certain patients makes sense?
Consider an uncomplicated ankle sprain. Evidence-based decision rules can rule out an ankle fracture with greater precision than a physician's diagnosis.
Physical therapists can refer for imaging when appropriate or treat immediately - saving costs and getting patients productive more quickly.
Similar characteristics between my PT eval and a physicians' eval include the following:
- History: Detailed
- Examination: Detailed
- Medical Decision Making: Moderate Complexity