AMA on Track to Revise E/M Codes — Set New Documentation Guidelines

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The AMA’s CPT Editorial Panel approved sweeping changes to documentation and code selection guidelines for evaluation and management codes.

If finalized, the changes would shift the way practices select codes for both office and facility visits as soon as January 2021.

Approved changes include:

  • Deleting level 1 office new patient E/M code 99201.
  • Removing history and exam as key components for selection of the E/M service level. The practitioner would be required to document that these elements were performed in order to report an office visit code.
  • Practitioners would select E/M codes based on either 1) the level of medical decision making (MDM) or 2) the total time spent performing the service on the day of the encounter.
  • A plan to revise the E/M guidelines into three sections:
    • Guidelines common to all E/M services
    • Guidelines specific to office and other outpatient visits
    • Guidelines specific to E/M services in the facility setting, including observation, hospital inpatient, consultations, emergency department, nursing facility, domiciliary, rest home or custodial care and the home setting.
  • A major overhaul of the MDM documentation guidelines to emphasize complexity of the conditions being addressed in place of the number of diagnoses reported.

Read more details and find out how you can make your voice heard on these proposed changes at the Part B News blog.

Source: DecisionHealth (3-12-19)

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