tci ED Coding & Reimbursement Alert - 2020 Issue Q2

Reader Question: Not So Fast on Changing E/M Guidelines

Question: We heard that as of January 1, we will no longer need all three E/M components (history, exam, and medical decision making (MDM)) and can just use time or MDM to select our E/M code. Our administrator said this isn’t the case. Is she right? Alabama Subscriber Answer: Yes, the administrator is correct when dealing with the ED E/M codes (99281-99285). Although CMS has scheduled such changes to take place for the office and other outpatient E/M codes (99201-99215) effective January 1, 2021, the ED codes are exempt from this rule. The concept of coding based on...

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