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Differentiated Coding for Expanded Problem Focused, and Detailed Levels of Evaluation and Management, No Longer Mandatory as of July 1

Wednesday, June 28, 2017

Differentiated Coding for Expanded Problem Focused, and Detailed Levels of Evaluation and Management, No Longer Mandatory as of July 1

 

Differentiation in examination requirements for Expanded Problem Focused (EPF, 2-5) and Detailed (6-7) levels of service developed by the National Government Services (NGS) will no longer be considered mandatory as of 7/1/2017. This delineation of levels, initiated in response to provider queries about the original standard, which included both EPF and Detailed at 2-7, has received strong provider support as a means of more accurately coding services. Providers may continue identifying levels 2-5 and 6-7 or, use the original 2-7.

These suggestions apply to services coded per the Centers for Medicare & Medicaid Services (CMS) 1995 Documentation Guidelines for Evaluation and Management Services. They do not apply to services coded per the CMS 1997 Documentation Guidelines for Evaluation and Management Services.

The NGS Evaluation & Management Documentation Training Tool, posted on www.ngsmedicare.com 6/14/2017 reflects the 2-7 exam component standard for both coding levels, and will remain unchanged.

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