Certified E/M coders, or evaluation and management coders, are a specialty profession that is in demand. Evaluation and management is a field that is always in high demand as medical facilities of all types require E/M coders for their billing needs. Read om to learn more about what E/M coding is and how to become an E/M coder.
What is E/M Coding?
Evaluation and management coding or E/M coding is a medical coding process that supports medical billing. In the United States, health care providers must use E/M coding to be reimbursed by Medicare, Medicaid, or private insurance companies and occasionally outpatient facility services for patient encounters. These codes are based on the CPT (Current Procedural Terminology) codes established by the American Medical Association and were established by Congress in 1995 and revised in 1997.
Evaluation and management coding applies to visits and services that involve evaluating and managing patient health; as such, most patient visits will require an E/M code when billing. There are different levels of E/M codes determined by the complexity of a patient visit and the documentation required.
The E/M guidelines have been adopted by private health insurance companies as the standard for determining the type and severity of patient conditions. Physician-patient encounters are translated into five-digit CPT codes using E/M coding to facilitate billing and allow medical service providers to document and bill for reimbursement for services provided. Some examples of E/M services include office visits, hospital visits, home services, and preventive medicine services. As well, some facilities and practices may use E/M codes internally to assist with tracking and analyzing the services they provide.
What Do E/M Coders Do?
As an E/M coder, you’ll select billing codes based on a patient’s health record. You’ll play an essential role in the healthcare system, analyzing and understanding physician’s documentation and medical terminology to select the most appropriate code for billing. Accurate coding helps ensure that charges are correctly made to the patient or insurance company for the services rendered.
Evaluation and management coders typically work in administrative settings such as at a physician’s office, hospital, or other healthcare facilities; alternatively, some may work for government agencies. They work as medical records and health information technicians, specializing as medical coders and coding specialists. Most E/M coders work full-time, typically in an office where they don’t interact with patients.
E/M coding can be challenging work as there are often many factors involved in selecting the correct code. Many E/M codes require the coder to determine the type of history, examination, and medical decision making, which can include using special grids and tables to check the requirements for.
As an E/M coder, you’ll need to stay up to date on all E/M coding rules, as small coding mistakes can cause significant compliance and payment issues if the errors are repeated across a large number of claims. Some areas to watch are the Centers for Medicare and Medicaid Services and the American Medical Association, as they implement changes for office and outpatient E/M coding and documentation.
Education and Career Requirements
Evaluation and management coders must have at least an associate’s degree in health information and technology. This covers topics such as communications, math, data and office management, health sciences, and coding procedures. You’ll also need to understand standard medical coding systems such as Current Procedural Terminology and potentially International Classification of Diseases – Clinical Modification, and Healthcare Common Procedure Coding Systems. You can also earn a bachelor’s or master’s degree in health information management, which could enhance your chances of obtaining employment in a specialty position such as E/M coding; however, it’s not required as specialty employment usually relies on experience. Most employers require two years of coding experience in addition to an associate’s degree.
While not required, earning a certification in the medical coding and health information technology field can provide opportunities for career advancement. Acquiring this certificate shows that you have a specialty in coding and demonstrates an ability to work with computers and provide accurate, efficient data management.
Some options for becoming credentialed are the Certified Evaluation and Management Coder (CEMC) and Certified Professional Coder (CPC) exams. Before taking these tests, two years of coding experience is highly recommended and even required for the CPC test; an associate’s degree is also recommended before going for your credentials. These tests focus on areas such as time-based coding, risk assessment, Medicare billing regulations, and medical terminology.
Job Outlook and Salary
According to the U.S. Bureau of Labor Statistics, in 2020, the median annual salary earned by medical records and health information technicians was $44,090. Jobs in the E/M field are projected to grow at a higher than average rate by 8% from 2019 through 2029. Most E/M coders work in clinics or hospitals, hold associate’s degrees, and can earn a professional certification that can result in a higher salary.
Getting Started as an E/M Coder
At Desert Medical Careers, we have years of connections with facilities where we’ve placed hundreds of individuals looking for medical positions. We help to review your resume, ensuring it matches what medical facilities are looking for. Desert Medical Careers provides interview tips based on our experience placing hundreds of applicants in their desired positions.
If you’d like to be placed in a E/M coding position, contact Desert Medical Careers at (602) 468-6300 or fill out the form below to get contacted by a DMC expert.
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Resources:
- AAPC – https://www.aapc.com/certification/specialty/cemc/
- Study.com – https://study.com/articles/Evaluation_and_Management_E-M_Coding_Jobs_Career_Options_and_Requirements.html
- Plianced.com – https://www.plianced.com/compliance-wiki/e-m-codes-evaluation-and-management-coding-documentation-guidelines/
- Wikipedia – https://en.wikipedia.org/wiki/Evaluation_and_Management_Coding
- AAFP – https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/evaluation-management.html
- AAPC – https://www.aapc.com/evaluation-management/em-coding.aspx