Evaluation and management (E/M) codes are a breed of codes like no other. They have very specific guidelines that must be followed in order to substantiate medically necessary billed services. There are specific requirements for the history and examination, and extensive information is required for the decision-making. But what do you do with your well-documented visit notes and the time spent with your patient who doesn’t fit the E/M service mold? You may have the ability to receive reimbursement by using one of the modifiers established specifically for E/M services.