Q&A Sequencing of E&M codes

[Amy J Golden]

I would like to find information on sequencing of E&M codes and other CPT codes. I was always taught you sequence your codes by the RVU from highest to lowest. I thought this was standard for all billers/coders. Our new EHR system pulls the E&M code to the middle or bottom of the charge ticket. The new EHR system rep has told me just to bill however it pulls on the ticket that it doesn't matter. She said unless I can provide her examples of why the E&M should be sequenced at the top, or whey CPTs should be sequenced then she will not proceed with getting this to pull over the sequenced way. Example:

87880
99214

or
36415
85025
70210
85008
84443
99203
96372
J0696

To me this looks awful and again, I have always billed the E&M code as the first procedure. Does anyway have any good views on this?

 

[Paul A]

This question came up on the AAPC forum recently. Although the way most do is by RVU order, there is no actual requirement any more. It was more of an issue when claims were processed by hand. The insurance company I work for order has never been an issue. When we do Surgical claims even if the highest RVU is on line 5 and lowest on Line 1 our system will still apply modifier 51 to line 1.