E/M coding: Sweeping E/M code, documentation changes emerge ahead of 2021 start date

Subscribe or sign in to view the full article.

Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains major evaluation and management (E/M) office visit changes that were previewed ahead of the 2021 effective date. It covers the shift toward time- or medical decision-making-based selection, documentation implications, revised office code structure, and the new prolonged service add-on. The discussion is aimed at coders, billers, compliance staff, and clinicians who need to understand how the updated guidance may affect office visit documentation and reporting across payers.

Why This Topic Matters

The changes described affect how common office visits are documented and selected, which can influence compliance, workflow, and reimbursement for many practices. Early understanding helps organizations prepare documentation processes, staff training, and time-tracking practices before the new rules take effect.

Article Sections

  1. Overview of the upcoming E/M changes

    Introduces the planned shift in office visit reporting and the source of the updated guidance. Summarizes the broader context for the 2021 changes.

  2. Slimmed-down code descriptions

    Discusses the planned restructuring of office visit code descriptors and the removal of one code from the new-patient office visit set. Compares the existing approach with the revised framework.

  3. Understand time-based reporting

    Explains the revised approach to counting time for office visit selection and the general categories of work that may be included. Notes how the time-based framework may affect different practice types.

  4. Map out MDM

    Reviews the updated medical decision-making framework at a high level and how it differs from older documentation concepts. Describes the broader elements that shape code selection under the revised guidance.

What You Will Learn

  • How the upcoming E/M office visit update changes documentation focus
  • What general types of information are emphasized under the revised time-based and MDM-based approaches
  • Why the office visit code structure is being revised ahead of the 2021 start date
  • What kinds of practice workflows may need review before implementation

Who Should Read This

  • Medical coders
  • Professional billers
  • Compliance staff
  • Physicians and other qualified health care professionals
  • Practice administrators

Codes Discussed

Code Ranges Discussed

  • CPT: 99205, 99215

Subscribe or sign in to view the full article.

Official DecisionHealth® Newsletter Archives includes:

  • Includes over 25,000 articles from:
    • Coder Pink Sheets
    • Part B News
    • Answer Books newsletters
  • Current newsletters added each quarter
  • Timely news and guidance vital for your practice
  • Fully searchable through Find-A-Code's Comprehensive Search
  • Codes mentioned in articles are linked to the Find-A-Code Code Information pages
  • Code Information pages link back to related articles
  • Save yourself tons of research time, find everything in one place!
Access to this feature is available in the following products:
  • DecisionHealth Coding, Billing and Compliance Library

Related Articles

Articles are listed in order of calculated relevance.

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.

Aimee- AI -powered coding assistant - Try it now for Free Would you like Aimee - AI
to help you with this?