E/M 2021- Do I have to use the revised guidelines?

E/M 2021- Do I have to use the revised guidelines?

July 23, 2020

Question:
I work with a sports surgeon and we see just a few Medicare patients. The surgeon believes the revised 2021 E/M guidelines will not impact our office practice because of our low Medicare volume.
Is this correct?

Answer:
This is not correct, but it is a common misconception. The revised documentation requirements are from CPT. These are the folks that write the codes, not a specific payor.  The changes were essentially agreed to by CMS, but they are changes to the code descriptors and guidelines in CPT.  One of the primary goals of the change, other than simplification, is standardization.  We know that commercial payors and CMS have a variety of documentation standards to support a level of E/M service. Beginning in January 1, 2021, CPT has standardized the documentation of the specific level of new and established outpatient visit, which should be applicable to all commercial and government payors.

*This response is based on the best information available as of 07/23/20.

REGISTER TODAY!

NEW ORTHOPAEDIC VIRTUAL MEETING AVAILABLE

2021 E/M GUIDELINES FOR ORTHOPAEDICS

New Dates Available!

 

 

REGISTER NOW

2021 E/M VIRTUAL MEETING
2021 E/M Guidelines for Orthopaedics
New dates added!

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches