decisionhealth Newsletters, Part B News - 2019 Issue 10 (October)
Decision time: Navigate revisions to levels of MDM amid coming E/M changes
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Article Overview
This article reviews forthcoming changes to office/outpatient evaluation and management coding, including the shift in how medical decision-making is assessed and how providers may document visits. It is aimed at medical practice leaders, coders, and clinicians preparing for the 2021 CPT updates and related workflow, template, training, and audit considerations. The discussion stays focused on broad changes to E/M service selection, documentation expectations, and implementation planning.
Why This Topic Matters
The article helps practices anticipate major E/M workflow and documentation changes so they can update training, templates, and internal processes before the effective date.
Article Sections
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Why the change is taking place
Introduces the context for the E/M revisions and explains why the office/outpatient portion of the E/M chapter is being updated. Summarizes the broader documentation concerns prompting the changes.
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Glimpsing the 2021 outlook
Outlines the major upcoming revisions in the E/M chapter and the broad shift in how office/outpatient service levels will be supported. Describes the overall structure of the changes affecting documentation and code selection.
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Calculating MDM: A new frontier
Reviews the revised medical decision-making framework and its major components at a high level. Covers the new table structure and the general categories used to assess service complexity.
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Take steps to implement the change
Focuses on practice preparation, including education, template updates, documentation review, and planning for the effective date. Addresses operational steps for adapting to the new E/M environment.
What You Will Learn
- The broad reasons the office/outpatient E/M framework is changing
- How the 2021 CPT E/M updates affect documentation and service-level selection
- The general components used in the revised medical decision-making structure
- What practice leaders may need to update in workflows, templates, and training
- Why preparation and internal review are important before the new rules take effect
Who Should Read This
- Medical practice leaders
- Physicians
- Non-physician practitioners
- Coders
- Compliance and billing staff
- Practice managers
Codes Discussed
Code Ranges Discussed
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