BC Advantage - 2020 Issue 10

Prepare Now for Gray Areas in 2021 E/M Rules

It's not even 2021 yet, but gray areas have already surfaced in the 2021 E/M documentation guidelines, as more and more coders and auditors read the fine print. The 2021 guidelines, which will apply only to outpatient/office visit codes 99202-99215, are being implemented in part to eliminate so-called "gray areas" - instances in which the official guidelines offer no specific guidance, or offer guidance that can be interpreted in multiple, mutually exclusive ways.The longstanding 1995 and 1997 E/M guidelines were riddled with such vagaries, but coders, auditors, and providers eventually accounted for them by deciding on a specific...

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