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E&M AUDIT FORM - Welcome to URMC

Revision 10/06 E&M AUDIT form Patient Name MR# DOS Provider Insurance Dept. Type of Service INPATIENT OUTPATIENT Initial Hospital Care 99221-99223 New 99201-99205 Subsequent Hosp Care 99231-99233 Established 99211-99215 Initial Consult 99251-99255 Consultation 99241-99245 Discharge Services 99238-99239 Emergency Care 99281-99285 Critical Care 99291-99292 (time-based) Observation 99218-99220 Nursing Home 99304-99316 Observation Discharge 99217 OUTPT DIAGNOSIS.

Revision 10/06 E&M AUDIT FORM Patient Name MR# DOS Provider Insurance Dept. Type of Service INPATIENT OUTPATIENT Initial Hospital Care …

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