The purpose was to assess a Web-based learning module for residents on evaluation and management coding, and to determine whether using a point system based on reimbursement is an effective way to measure improvement in performance.

Nineteen residents at a university-based residency completed an online module on evaluation and management coding. Pretest and posttest were administered consisting of 10 actual patient notes from which to abstract the level of service. Tests were scored by percent correct as well as assigning points to correct responses equal to 2004 Medicare reimbursement for that item's level of service. Incorrect responses were debited points equal to the absolute difference in reimbursement between the incorrect and correct evaluation and management level.

Average percent correct was 44.2 on the pretest and 45.3 on the posttest (P = 1.0), with only 47% of subjects improving their performance. The mean point score was 513.44 on the pretest and 555.87 on the posttest (P = .02), with 84% improving. Most subjects (84%) rated the module equal or superior to a didactic format and felt that their knowledge was improved by the exercise.

An electronic learning module on evaluation and management coding for residents, using scoring based on reimbursement schedules, is effective for instruction and assessment and well accepted by learners.