HCPro, JustCoding Outpatient - 2019 Issue 33 (August)
E/M in flux: Key documentation changes loom, payment boost anticipated
August 13th, 2019
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Article Overview
This article summarizes proposed updates in the 2020 Medicare Physician Fee Schedule affecting office/outpatient evaluation and management services. It is aimed at coders, billers, physicians, and practice leaders who need to understand the direction of documentation changes, the shift in how office visits may be selected, and the expected payment impact for 2021. The discussion also covers related additions and replacements in the office visit code structure and how the changes fit with AMA and CMS guidance.
Why This Topic Matters
The proposed changes could alter how common office visits are documented, reported, and reimbursed, making them important for compliance, workflow, and revenue planning.
Article Sections
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Documentation and coding changes for office/outpatient E/M services
Summarizes the proposed changes affecting office and outpatient evaluation and management reporting. Covers the shift in documentation approach and the overall direction of CMS and AMA guidance.
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Medical decision-making and time-based selection
Explains the proposed focus on medical decision-making and time as selection methods for office visit levels. Discusses how the revisions relate to documentation structure and practice workflow.
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Proposed payment infusion
Reviews the projected payment impact tied to the revised office visit structure. Includes discussion of estimated rate changes and the broader revenue implications for practices.
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New prolonged care code emerges
Covers the proposed replacement approach for prolonged office and outpatient services. Describes the new add-on code concept and its relationship to higher-level office visits.
What You Will Learn
- What proposed changes are being made to office and outpatient E/M services
- How documentation emphasis is expected to shift for office visit reporting
- What general payment effects are anticipated from the proposed rule
- How prolonged office and outpatient services are being restructured
- Which organizations and guidance frameworks are influencing the changes
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Practice managers
- Compliance teams
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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