E/M Coding Alert - 2020 Issue 12
Reader Questions: Calculate Time for Office E/M in 2021
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Article Overview
This reader Q&A discusses office/outpatient evaluation and management reporting in 2021, with a focus on time-based code selection and how different guidance sources describe what time may be counted. It is relevant for coders, billers, and compliance staff who work with CPT office E/M services and need to understand the scope of the time calculation guidance described in the article.
Why This Topic Matters
The article helps readers understand that time-based E/M reporting can be interpreted differently depending on payer or guidance source, which can affect code selection and compliance for office visits.
Article Sections
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Question
A reader asks about counting time before and after an office visit when selecting an E/M level in 2021.
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Answer
The response addresses whether time outside the face-to-face encounter may be considered under certain circumstances.
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Basics
This section summarizes the 2021 shift in office/outpatient E/M reporting and the general move to time-based selection.
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CPT® versus CMS
This section contrasts AMA training language with CMS discussion in the 2021 Physician Fee Schedule proposed rule.
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Bottom line
The closing note emphasizes that payer guidance may differ and that additional clarification was expected later in the rulemaking process.
What You Will Learn
- How 2021 office/outpatient E/M time-based reporting is described in the article
- How the article contrasts AMA and CMS guidance on counting time
- Why payer-specific guidance matters for office visit time calculation
- What general categories of time are discussed for E/M reporting
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
- Physician office staff
Codes Discussed
Code Ranges Discussed
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