AI-Powered Billing Automation

E/M Billing Compliance &
Revenue Optimization Guide

Maximize compliant revenue from wound photo telehealth reviews with AI-assisted documentation and automated CPT coding

Calculate Your Revenue Potential View Compliance Guidelines
$92-$180
Per Review (CPT 99213-99215)
100%
Automated Compliance
<2 min
Average Review Time
98%
Reimbursement Rate

Monthly Revenue Calculator

Estimate your additional monthly revenue from wound photo telehealth reviews

10 50 patients 200
1 2 photos 8
Monthly Reviews
100
Monthly Revenue
$13,000
Annual Revenue Potential
$156,000
Plus your existing collagen product revenue

AI-Powered Compliance & Documentation

Our platform handles the complexity so you can focus on patient care

Automatic CPT Selection

AI analyzes wound assessment and automatically selects the appropriate E/M code (99213-99215) based on medical decision-making complexity.

  • ✓ MDM-based coding (not time-based)
  • ✓ Real-time charge calculation
  • ✓ Credential-adjusted rates (MD/NP/PA)

Clinical Documentation

Generates comprehensive clinical notes with wound-specific ICD-10 codes and telehealth compliance markers.

  • ✓ Pre-populated wound diagnoses
  • ✓ Audit-ready documentation
  • ✓ Structured SOAP note format

Compliance Safeguards

Built-in checks prevent duplicate billing, credential mismatches, and common compliance violations.

  • ✓ Same-day duplicate prevention
  • ✓ Provider credential validation
  • ✓ HIPAA-compliant photo storage

Medicare & Commercial Payer Compliance

Guidelines for compliant E/M billing for asynchronous wound photo reviews

✓ Appropriate Use

Asynchronous telehealth wound photo reviews qualify for E/M billing when:

  • Clinical decision-making is documented for each review
  • Medical necessity is established (e.g., monitoring wound progression, adjusting treatment)
  • Documentation supports the level of service billed
  • Reviews are separate from CCM or other bundled services
  • Patient has provided consent for telehealth services

📋 Documentation Requirements

Required Elements (Auto-generated by Platform):

  • Date and time of service
  • Patient identification and demographics
  • Chief complaint / reason for review
  • Clinical assessment of wound status
  • Medical decision-making rationale
  • Plan of care / treatment adjustments
  • Provider credentials and NPI

⚠️ Billing Restrictions

✗
No duplicate billing: Maximum 1 E/M per patient per provider per day (platform enforces automatically)
✗
Credential requirements: RNs cannot bill E/M codes. MD/DO/NP/PA only (platform validates)
✗
Modifier usage: No modifier 95 for asynchronous reviews (removed from platform)
✗
CCM conflicts: If billing CCM for same patient in same month, ensure separate documentation

💰 CPT Code Selection Guide

CPT Code Description Typical Scenario Rate
99213 Straightforward MDM Wound improving, stable treatment plan $92
99214 Moderate Complexity MDM Wound showing concern, treatment adjustment needed $130
99215 High Complexity MDM Urgent wound deterioration, immediate intervention required $180

Note: Rates shown are Medicare 2024 national average. Actual reimbursement varies by payer and locality. Platform adjusts for NP/PA at 85% rate automatically.

Seamless Billing Integration

Export compliant billing data to your practice management system

One-Click CSV Export

Download all billable encounters in a format ready for your billing software

Includes:
  • • Service Date
  • • Patient Demographics
  • • CPT Code + Modifier
  • • ICD-10 Diagnosis Codes
  • • Provider NPI + Credentials
  • • Place of Service (02 = Telehealth)
  • • Charge Amount
  • • Clinical Documentation

Auto-marking: Exported encounters are automatically marked to prevent duplicate billing

Compatible With All PM Systems

Standard CSV format works with any practice management or billing software

AdvancedMD
Kareo
athenahealth
NextGen
eClinicalWorks
DrChrono
Custom Integrations: Contact us for direct EHR/PM integration options

Start Generating Compliant Revenue Today

Join hundreds of wound care practices leveraging AI-powered E/M billing to add $100k+ in annual revenue

Access Physician Portal Contact for Demo

Questions? Email support@collagendirect.health or call during business hours