decisionhealth Newsletters, Coder Pink Sheets - 2022 Issue 7 (July)
E/M update 2023: Navigate new combo observation/inpatient codes to prepare for 2023
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Article Overview
This article explains the 2023 transition in CPT E/M coding for hospital observation and inpatient services. It focuses on the shift to MDM- or time-based code selection, the consolidation of observation services into inpatient hospital codes, updates to MDM guidance, and the impact of same-day E/M bundling changes. It also notes where CMS proposed policy differs from AMA guidance, making the piece relevant for coders, auditors, and compliance staff working with hospital-based E/M services.
Why This Topic Matters
The update affects how hospital observation and inpatient encounters are reported and how same-day E/M services are handled across AMA and Medicare guidance. Coders and billing teams need to understand the scope of the 2023 changes to support accurate reporting and policy alignment.
Article Sections
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Observation and inpatient code consolidation
Describes the overall shift in hospital E/M reporting and the consolidation of observation-related services into a streamlined hospital coding structure.
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Observation folds into inpatient
Explains the relationship between observation and inpatient hospital services under the revised framework and notes related descriptor updates.
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MDM table takes updates
Summarizes revisions to the medical decision-making guidelines and table as they apply to hospital-related encounters.
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Update unbundles same-day E/M services
Covers the revised handling of same-day E/M services when an encounter leads to a hospital admission or observation stay, including discussion of AMA and CMS differences.
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Resources
Lists reference materials and source documents cited by the article.
What You Will Learn
- How the 2023 CPT update changes hospital observation and inpatient E/M reporting
- Which areas of hospital E/M guidance were revised for 2023
- How the article frames differences between AMA guidance and CMS policy
- What categories of documentation and guideline changes are discussed for hospital-based E/M services
Who Should Read This
- Medical coders
- Coding auditors
- Compliance staff
- Hospital billing teams
- Physician practice administrators
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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