2021 E/M Updates

CE Medical Group Blog Post



2021 E/M Updates

By Melissa Billman, Director of Billing at CE Medical Group

There are many billing and coding updates coming in 2021 to be prepared for. SPPM and C E Medical Group has collaborated to help summarize them for you. Here are the key changes highlighted in this post.

Key Changes to E/M Coding:

• 99201 has been deleted.
• History and physical exam as elements for code selection was eliminated.
• More Additional detail added to coding description and guidelines to promote payer consistency.
• Guidance added on when comorbidities and underlying diseases are to be counted for medical decision making.
• Physicians now choose whether they document based on MDM or total time.

AMA states the key reasons behind the changes are:

• “Eliminating history and physical exam as elements for code selection. While significant to both visit time and medical decision-making, these elements alone should not determine a visit’s code level.
• Allowing physicians to choose whether their documentation is based on medical decision-making or total time. This builds on the movement to better recognize the work involved in non-face-to-face services like care coordination.
• Changing medical decision-making criteria to move away from simply adding up tasks to instead focus on tasks that affect the management of a patient’s condition.”