decisionhealth Newsletters, Part B News - 2022 Issue 7 (July)
AMA unveils anticipated E/M changes for facility-based services
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Article Overview
This article explains the AMA’s early release of evaluation and management updates for the 2023 CPT manual. It focuses on changes affecting facility-based services, including shifts in how visits are structured and reported across multiple settings, revisions to documentation and MDM guidance, and updates that align several code families with the office visit framework. It is relevant to coders, billers, compliance teams, and clinicians who report E/M services in hospital, observation, nursing facility, home, and consultation settings.
Why This Topic Matters
The changes described affect how a wide range of facility-based E/M services will be organized and reported under CPT beginning in 2023. Readers need this context to understand the scope of the upcoming revisions and identify which service categories may be impacted.
Article Sections
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Overview of the 2023 E/M guideline release
Introduces the early release of AMA E/M updates and the effective date for the revised CPT guidance.
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Facility-based visit framework changes
Summarizes the broader shift in E/M structure across hospital, observation, emergency department, nursing facility, and home or residence settings.
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Service guidelines and MDM updates
Covers revisions to introductory service definitions, medical decision-making content, and related guidance for applying the updated framework.
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Other changes of note
Highlights additional revisions affecting consultations, domiciliary and nursing facility reporting, prolonged services, and related code families.
What You Will Learn
- Which E/M service categories are affected by the upcoming CPT updates
- How the article frames the move toward broader consistency across E/M sections
- What types of guideline areas are being revised, such as service definitions and MDM structure
- Which reporting categories are being deleted, merged, or replaced in the updated guidance
- How the article situates prolonged services and consultation-related changes within the broader update
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Compliance teams
- Physician practices
- Facility revenue cycle staff
- Clinicians who document and report E/M services
Codes Discussed
Code Ranges Discussed
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