E/M Guideline Changes for 2021
2021 brings about a new year and dramatic change to the Documentation Guidelines (DG) for selecting Evaluation & Management (E/M) services in the outpatient setting. The DG clinicians, coders, auditors, and payers have been used to since the 1995 and 1997 revamp has undergone significant change and everyone involved in assigning and reviewing E/M code set 99201-99215 has to become very familiar and knowledgeable with these new guidelines.
Presenters at this session will review why "medical necessity" will become even more critical in 2021 with the removal of the history and physical exam components for E/M leveling. They will keenly focus on medical decision making and time-based billing and will cover those gray areas we have all been exposed to, along with common pitfalls, education opportunities, and best practices for implementation. Finally, they will discuss how these changes impact revenue cycle, CDI, and operations, and how providers should strategically use internal and external resources to optimize time and practice expense.
After completing this session, participants will:
• Have knowledge of the documentation changes already in effect as a result of the CY 2019 Physician Fee Schedule Final Rule.
• Be aware of the 2021 evaluation & management (E/M) documentation requirements.
• Have a better understanding of the AMA's new medical decision making (MDM) risk table.
• Be able to compare documentation requirements for the current vs. impending guidelines.
• Have access to tips for educating providers.
• Be able to share with others best practices for implementing the new guidelines.
Leonta Williams, MBA, RHIA, CPCO, CCS, CPC, CCDS, CHONC, CEMC, CRC
Medical Records, GA Cancer Specialists/Northside Hospital Cancer Institute Atlanta, GA