Are You Updated on the 2022 E&M Profee Shared Visit Requirements?

Are You Updated on the 2022 E&M Profee Shared Visit Requirements?

With the new 2022 Shared visit changes, modifier FS is to be reported on the E/M code.

One of the more difficult challenges in shared visit documentation is determining which provider has completed the substantive portion of the service. Even though the guidelines are clear on who gets the credit, when we review documentation from the coding perspective it is sometimes a bit muddy and difficult to determine who performed the service.  The challenge unfolds when we have the midlevel doing the substantive portion of the visit and the provider then also documents another substantive portion in their attestation.

What does substantive mean?

  • Performing and documentation of the history;
  • Or performance and documentation of the physical exam;
  • Or performance and documentation of the medical decision making;
  • Or spending more than half the total time of the encounter.

Educating providers on the documentation requirements is the key to appropriate billing.  Template changes, query processes, and/or policies and procedures might also help mitigate any issues with determining appropriate billing. 

At LexiCode, we have provided our team with in-depth education around shared visit documentation and requirements and work with the client to determine appropriateness when the documentation is not clear. 

The complete policy and final rule is available - CY 2022 PFS final rule.

Tricia Jolin, RHIA, CCS-P, CPC, CIRCC

“We recommend LexiCode without hesitation. For many years, LexiCode’s has provided high quality audit services to support our compliance program. The formal audit deliverables and reports far surpass any I have seen in the industry; they translate all of the audit data into meaningful and useful information. All other aspects of the audit process demonstrate a commitment to excellent customer service. We also love the annual coding education modules that LexiCode offers!”

Rachel C. Sherksnas, RHIA, VP Health Information Management
Post Acute Medical