ED Coding & Reimbursement Alert - 2020 Issue 3
Evaluation and Management: Prepare for 2021 E/M Changes That Will Affect Your Surgery Practice
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Article Overview
This article explains the major 2021 evaluation and management changes affecting surgery practices, with emphasis on CMS policy updates, CPT revisions, documentation expectations, and how payment may shift for office and outpatient services. It is intended for surgeons, coders, compliance staff, and practice managers who need a general understanding of the transition and the kinds of guidance covered in the article.
Why This Topic Matters
The changes discussed may affect how office and outpatient visits are documented, reported, and reimbursed. Practices need early awareness to prepare workflows, coding processes, and financial planning for the updated E/M framework.
Article Sections
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You Should Be Doing This Now
Current documentation-related changes that practices are expected to review before the main E/M overhaul takes effect. The section focuses on who may document certain history elements and related workflow considerations.
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Prepare for 2021 Changes
A summary of the upcoming E/M framework for office and outpatient services. It covers the general shift in how visit levels will be determined and the related CPT and CMS updates.
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Preview Pay Changes
Discussion of anticipated reimbursement effects associated with the revised E/M structure. The section addresses broader payment implications and budget-neutrality considerations.
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Check Out This Example
A case-based comparison illustrating how the evolving E/M framework affects office visit reporting. The section uses a sample surgical scenario to show the type of documentation themes addressed in the article.
What You Will Learn
- What the 2021 office and outpatient E/M changes mean for surgery practices
- How documentation expectations are changing for history-related elements
- How CMS and CPT updates may affect visit level selection
- Why payment impacts may vary across specialties and practices
- What types of documentation themes are highlighted in the article’s example
Who Should Read This
- Surgeons
- Medical coders
- Coding auditors
- Compliance staff
- Practice managers
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
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