Evaluation and Management (E/M) Coding and Re-Exams: Getting It Right and Getting It Paid

Evaluation and Management (E/M) Coding and Re-Exams: Getting It Right and Getting It Paid

Hour 1 — Making Sense of E/M Coding for Chiropractors

Description
Chiropractors must comply with the same E/M documentation rules as other healthcare providers—but most guidelines were never written with chiropractic in mind. In this first hour, Dr. Gwilliam simplifies the 2021–2024 E/M changes, showing which rules actually apply in a chiropractic setting and how to use them to accurately select and document the proper level of service. Attendees will gain practical examples and note verbiage that make E/M compliance less confusing and more consistent.

Learning Outcomes

• By the end of this hour, attendees will be able to:
• Interpret the 2021–2024 E/M coding guidelines as they apply to chiropractic encounters.
• Differentiate between MDM-based and time-based code selection, and identify which is most defensible in chiropractic practice.
• Construct compliant documentation that supports the selected E/M level and withstands payer review

Hour 2 —  Re-Exam Reality Check: When E/M and CMT Can Coexist

Description
In this second hour, Dr. Gwilliam explores one of chiropractic’s most common billing and compliance headaches: performing and documenting a re-exam on the same day as a CMT. Learn how to identify when a re-evaluation is clinically justified, how to document it as a “significant, separately identifiable” service, and how to apply the correct modifiers and diagnosis pointers to minimize denials while maintaining ethical compliance.

Learning Outcomes

• By the end of this hour, attendees will be able to:
• Identify clinical situations that justify a separately reportable E/M service in conjunction with CMT.
• Apply payer and coding guidance—including the 25 modifier and NCCI edits—to create compliant re-exam documentation.
• Distinguish between routine care and medically necessary re-evaluations to ensure accurate, defensible records.