Evaluation and Management Coding Changes for 2021 – Let’s be Proactive:
Evaluation and management changes are set and will be implemented beginning January 1st 2021. Is your facility equipped? Are your clinicians ready for the new documentation challenges?
Why the change?
The changes are a direct result of the documentation issues existing in the current healthcare delivery system. Complaints from physicians regarding the amount of time spent on documentation practices versus time spent with patients have previously been an issue for providers. Under the new CPT 2021 guidelines CMS has proposed that more time be spent with patients and less on documentation, which will allow providers to generate resource based reimbursement. With the definitions and guidelines being extended, there will also be less need of audits.
What’s changing?
- Beginning January 2021, clinicians/providers will be required to select the E/M visit based on time or medical decision making
- Five levels of coding will remain for established patients but be reduced to four levels for office or outpatient E/M visits for all new or incoming patients
- Revisions of code definitions
- Times as well as the medical decision making process will be modified for all codes
- Necessitate performance of history and exam, as appropriate (H&P will not be a major element in selecting an E/M code)
- CMS will be combining and boosting payment specifically for the add-on HCPCS code GPC1X, for office or outpatient Evaluation and Management visits for primary care and nonprocedural specialty care into one code that will illustrate the work associated with appointments that are part of ongoing complete primary care/encounters that are related to ongoing care associated with a patient’s single, grave or multifaceted chronic conditions
Note: This code is not projected to mirror a variation in payment by enrollment specialty, but to a certain extent, a better identification of differences between types of visits.
Let HIA take the helm and guide you through these critical documentation and coding changes.
At HIA our staff is knowledgeable in Practice Management. We are happy to assist with training and educating your staff with the upcoming documentation and coding changes. We will also assist with auditing to ensure that your facility is prepared to follow the new guidelines, improve productivity and internal processes. We are experts in coding education for various specialties across the country and we would be delighted to work with you. For more information about current or future coding guidelines/regulations or any other services we offer please contact us today.
