420
book over a weekend (it only took a few hours) and felt eminently more prepared.
My interest blossomed, and I attended a few billing courses. All of sudden, boom, I
became the go-to guy for billing in surgery at my institution. For 8 years I gave
yearly lectures for many of our divisions in surgery, and I am still learning.
Why is some random urologist passionate about a topic other than the strength
of your urinary stream? In a word: anger, annoyance, and pride. Fine, three words.
Anger (and thanks) stems from all the chart audits stating I overbilled (still arguing
about those) but never told me I under-billed had I just done this or that. This fueled
me to learn the coding and billing system. Annoyance that when I talked to some of
the brass about what I perceived as a clear deficiency (“improvement opportunity”)
in rampant under-billing and how I was willing to help, the crickets became deafen-
ing. Thanks to those who have encouraged and propelled my cause forward (you
know who you are). Pride in that I want you and your new practice to do well. In
retrospect, I can honestly say that learning E & M documentation and billing
improves the following:
- Patient care
- Medicolegal concerns
- Resident and medical student learning
- Research opportunities
Table 23.1 Relative value of established visit and timing thresholds
Established visits data
RV U % increase Time (min)
E1 0.18 5
E2 0.48 166 10
E3 0.97 102 15
E4 1.5 54 25
E5 2.I 40 40Table 23.2 Relative value of new and consult visits and timing thresholds
New and consult data
RV U % increase % change N⇢C Time (min)
Nl 0.48 10
N2 0.93 94 20
N3 1.42 53 30
N4 2.43 71 45
N5 3.17 30 60
Cl 0.64 33 15
C2 1.34 109 44 30
C3 1.88 40 32 40
C4 3.02 61 24 60
C5 3.77 25 19 80T.S. Köhler