Prepare Now for Gray Areas in 2021 E/M Rules

Why This Topic Matters

Understanding these ambiguous areas can help coding and compliance teams prepare for inconsistent interpretations and reduce internal variation in applying the 2021 E/M documentation rules.

Article Sections

1. Introduction

   Introduces the topic of ambiguity in the 2021 outpatient/office E/M documentation guidelines and contrasts it with earlier guideline frameworks.

2. What counts as a "unique test" when evaluating Medical Decision Making (MDM)

   Examines one area of uncertainty involving how test-related data may be counted within medical decision making under the 2021 guidelines.

3. Ordering and reviewing tests for MDM

   Discusses a second area of uncertainty involving how ordering and reviewing diagnostic tests may be reflected in medical decision making.

4. Conclusion

   Summarizes the article’s advice on handling ambiguities and notes that additional clarification may come from national organizations.