Coding, Classification and Reimbursement

E&M updates for 2020??

  • 1.  E&M updates for 2020??

    Posted 14 days ago

    Does anyone know, regarding the anticipated updates to E&M.:
    Are they updating ONLY the documentation requirements or will there also be changes to the CPT manual itself, i.e. EM code definitions?

    Will the changes in documentation requirement basically negate the 95 & 97 guidelines or will the bullet points etc still apply?
    Thanks for any insight you have.



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    Lorraine Papazian-Boyce
    President
    PB Resources, Inc.
    PB Resources
    Author, Pearson's Comprehensive Medical Coding: A Path to Success
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  • 2.  RE: E&M updates for 2020??

    Posted 13 days ago
    Hi Lorraine,
    The AMA has posted a bit more detail regarding some of the updates to E/M, but it is not very specific. It sounds like they are moving towards no longer requiring the history and exam portion to determine the E/M level, but rather either allowing either time-based or MDM to drive the level. Your providers still need to document the history and exam, but no more counting bullets and such. Since this pertains to Federal programs, I don't know if all payers will follow this or not. If the AMA is changing CPT to match the Medicare regs, one would think that all payers will follow, but it's a wait and see situation at this time.  I have also included a link to the Fed Reg and the AMA's post, if you would like to read this straight from the sources. I'm staying on top of this, so please feel free to email me directly at jharvey@lbmc.com and we can figure this out together.

    https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-16041.pdf
    https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management

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    Jenny Harvey, RHIT, CPHQ, CPMA, CPC
    Manager, Healthcare Consulting
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  • 3.  RE: E&M updates for 2020??

    Posted 13 days ago
    Hi Lorraine,
    Just letting you know that CMS just announced that they are having a Listening Session call on Monday 8/12 at 1-2:30 Eastern to discuss the E/M updates. You may register at the following link.  https://blh.ier.intercall.com/


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    Jenny Harvey, RHIT, CPHQ, CPMA, CPC
    Manager, Healthcare Consulting
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