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Billing & Coding in the Outpatient Setting

Billing & Coding in the Outpatient Setting

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Billing & Coding in the Outpatient Setting**


Billing & Coding in the Outpatient Setting is a quick reference guide to significant new changes in the Evaluation and Management (E/M) codes for inpatient office visits. These changes, which took effect Jan. 21, 2021, have far-reaching impacts on daily documentation and clinical practice. This book replaces the card set previously published by APEA (APEA Guide to Billing & Coding).


Billing & Coding in the Outpatient Setting is a concise but comprehensive reference for the exam room and office. It's portable and packed with key points NPs need to provide accurate and comprehensive documentation that supports services rendered and justifies reimbursement for the fees submitted.


Book contents include:

  • Determining whether the visit is for a New or Established Patient
  • Determining whether the E/M code should be based on Medical Decision Making or Time
  • How to document appropriately and how to avoid common documentation pitfalls
  • Tips for reimbursement
  • Recommendations for credentialing in order to bill for services
  • Telemedicine information
  • Incident-to billing information
  • Durable medical equipement information

**CORRECTION on page 7:

The first print run of this book contained an incorrect statement in patient example 2. This content should read as follows:


  1. You transfer from one practice to another. A patient you have seen within the last 3 years establishes care with you at the new site. Although this is a new site, the patient is not new to you and should be billed as an established patient.

Title: Billing & Coding In the Outpatient Setting

Author: Kathy Baldridge, DNP, FNP-BC, FAANP

Copyright: March 2021



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