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:
- Activities that don’t count toward a time-based visit.
- 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:
- Analyzed.
- Combination of data elements.
- Discussion.
- Unique – test and source.
- Surgery.
- Four MDM definitions were revised to better explain the following terms:
- Drug therapy requiring intensive monitoring for toxicity.
- Independent historian.
- Risk.
- 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.