tci Medicare Compliance & Reimbursement - 2019 Issue 12
E/M Coding: What’s on the Horizon for E/M in 2021? Find Out
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Article Overview
This article previews upcoming outpatient evaluation and management (E/M) coding changes associated with the 2021 implementation timeline. It is aimed at coders, auditors, compliance staff, and other revenue cycle professionals who need to understand the scope of CPT and CMS updates, the kinds of documentation and descriptor changes being discussed, and how these shifts may affect office visit coding workflows.
Why This Topic Matters
The article helps readers prepare for major E/M framework changes before they take effect, especially in areas that affect code selection, documentation expectations, and office visit level reporting. It is useful for organizations planning education, compliance review, and operational updates around outpatient E/M coding.
Article Sections
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99201 Will Go Away
Discusses the anticipated removal of a new patient office visit code and the expected operational impact on routine coding and auditing. Includes commentary from coding and compliance professionals.
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Expect History, Exam Component Removal, and MDM Revisions
Covers the planned shift away from history and exam as key selection elements and summarizes the proposed updates to medical decision-making terminology. Addresses the broader documentation framework for office visit coding.
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See How ‘Time’ Will Play a Part
Explains the planned emphasis on total encounter time alongside medical decision making for selecting E/M levels. Notes the related change from typical time language to total time on the date of the encounter.
What You Will Learn
- The broad scope of upcoming outpatient E/M coding changes
- How CPT and CMS updates are expected to affect office visit level selection
- What types of documentation framework revisions are being discussed
- How time-based reporting language is changing for E/M services
- Why coders and auditors are monitoring the 2021 transition
Who Should Read This
- Medical coders
- Coding auditors
- Compliance staff
- Revenue cycle professionals
- Physician practices
- Billing teams
Codes Discussed
Code Ranges Discussed
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