ElM$-$Evaluation and Management Levels

CPT code $99211($Level $1)$ pertains to an evaluation and management $($EM$)$ service. The CPT manual defines code $99211$ as an office or other outpatient visit "that may not require the presence of a physician. Usually, the presenting problem$($s$)$ are minimal. Typically, five minutes are spent performing or supervising these services.

CPT code $99212($Level $2)$ pertains to an evaluation and management $($E$/$M$)$ service. The presenting problems are usually self$-$limited or minor. The physician may spend $10-15$ minutes with the patient and$/$or patient and family. The assessment is limited to the presenting problems.

CPT code $99213($Level $3)$ pertains to an evaluation and management $($E$/$M$)$ service. The presenting problems are low to moderate severity. The physician may spend $15-20$ minutes with the patient andfor patient and family. The physician will do a detailed assessment.

CPT code $99214($Level $4)$ pertains to an evaluation and management $($E$/$M$)$ service. The presenting problems are moderate to high severity. The physician may spend $25-35$ minutes with patient andior patient and family. Special attention is given to symptoms individually and then as they relate to the entire clinical situation.

CPT code $99215($Level $5)$ pertains to an evaluation and management $($E$/$M$)$ service. The presenting problems are moderate to high severity. The assessment is broad encompassing all aspects of the patient's condition. Extended time is spent with the patient$/$family and coordinating care with a hospital or other healthcare services.

Note: Both graphs show the same information but in different graphical designs.

Thought process:

$1$ Start with January; figure out which color represents each level.

$2.$ Compare January with February, etc.

$3.$ Finally, compare January with December

$4.$ What changes do you see?

$-$Which levels have increased?

$-$Which levels have decreased?

$-$Are the increases$/$decreases good$/$bad$?$ Why?

$5.$ Why is there an increase? Decrease?

$6.$ What can an HIM professional do or what steps need to be taken?

Evaluate the Revenue Management Cycle Management Process

As a practice manager you are tasked with managing the revenue cycle. Vou run a yearly report that shows the distribution of $\frac{E}{M}$ levels billed for established patients.

Answer the following questions:

What conclusions can you draw from the graph?

Name at least thriee steps that should be taken as a result of your conclusinns?