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2021 E/M guidelines reshaped by dozens of technical corrections

Your 2021 CPT® manual doesn’t have the final word on how to document and code E/M visits. You need the Errata and Technical Corrections in CPT 2021 for the freshest E/M guidance.
Four technical corrections – “clarifications of original Panel intent for the current code structure” – make important changes to the guidelines, with most of the new information concentrated in the medical decision making (MDM) definitions for office and other outpatient visits (99202-99215). The AMA posted the additional guidance March 9, but it is retroactive to Jan. 1.
Here’s an overview of what’s new (subscribers to Part B News and DecisionHealth coding newsletters will find more details in upcoming issues):
  • Two revisions to the general E/M guidelines refine the following concepts:
  1. Activities that don’t count toward a time-based visit.
  2. Separately reported tests and interpretation.
The remainder of the changes are exclusive to MDM-based office visits.
  • The number and complexity of problems addressed guideline expands on the concept of morbidity and explains how risk is defined for this element (as opposed to the Risk element).
  • The instructions for selecting a code provide more information on when to count an ordered test.
  • Five new MDM definitions were added:
  1. Analyzed.
  2. Combination of data elements.
  3. Discussion.
  4. Unique – test and source.
  5. Surgery.
  • Four MDM definitions were revised to better explain the following terms:
  1. Drug therapy requiring intensive monitoring for toxicity.
  2. Independent historian.
  3. Risk.
  4. Test.
This off-schedule update should serve as a reminder to bookmark the Errata & Technical Corrections page and check it on a regular basis. The CPT editorial panel does not have a set schedule for the updates and changes may crop up at any time after the manual is published.
Editor’s note: Make sure your staff has a solid, up-to-date understanding of the new guidelines for office E/M codes 99202-99215. Register today for the half-day virtual conference: Eliminate E/M Pain Points: Conquer Early Challenges and Master Medicare Complexities, Wed., March 24, 11 a.m. – 4 p.m., ET. The event includes an hour of live Q&A and has been approved for 4 AAPC, 3.5 AHIMA and 3 BMSC CEUs.
Blog Tags: AMA, E/M services
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