decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 8 (August)
Breaking news: Sweeping E/M code, documentation changes emerge ahead of 2021 ready date
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Article Overview
This article explains the AMA’s preview of major office and outpatient E/M updates slated for 2021. It covers how the revised guidance shifts reporting toward time or medical decision-making, how the code set is being reorganized, and why these changes matter for physicians, coders, and practice managers preparing for implementation.
Why This Topic Matters
The article helps readers understand a significant shift in office E/M documentation and code selection that can affect workflow, training, compliance, and reimbursement planning across payer types.
Article Sections
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Three rules to share with staff
A high-level summary of the main workflow changes practices are being asked to communicate to staff. It frames the major differences in how office and outpatient visits will be reported under the new guidance.
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Expand training with more details
Discussion of planned code-set revisions for office E/M services and the move toward shortened code language with updated time elements. It also introduces the broader scope of the revisions for new and established patient visits.
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Understand time-based reporting
An explanation of how the time-based approach is described in the article, including the types of activities that may be included on the date of service. The section also notes how practices may use this information to evaluate workflow and coding patterns.
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Map out MDM
Coverage of the revised medical decision-making framework and the categories used to evaluate office visit complexity. It also discusses how practices may think about selecting visit levels under the updated structure.
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Typical times vs. planned times for 2021
A comparison chart showing current typical times against planned time ranges for office and outpatient E/M codes. This section is presented as a reference for understanding the scope of the 2021 timing updates.
What You Will Learn
- How the AMA’s preview affects office and outpatient E/M documentation planning
- What broad changes are being made to time-based and MDM-based visit reporting
- How practices can think about preparing staff and workflows for the updated guidance
- What types of reference information the article provides for comparing current and planned office E/M timing
Who Should Read This
- Medical coders
- Physician practices
- Compliance staff
- Billing managers
- Physicians and other qualified health care professionals
- Practice administrators
Codes Discussed
Code Ranges Discussed
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