Major E/M Coding Changes Coming in 2021: Here’s What You Need to Know

The most significant evaluation and management (E/M) guideline change for ambulatory practices in over 20 years will occur on January 1, 2021. There are two crucial facts that every healthcare organization should be aware of in regards to these changes:

  1. The E/M coding changes will require specific action for every healthcare provider.
  2. Unlike many changes that often increase burdens and create more or new challenges, these new or updated guidelines present positive changes that healthcare providers can take advantage of in a variety of ways.

The guideline change is a collaboration between the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS), focusing on the Patients over Paperwork initiative.In summary, the new guidelines affect only new and established office/outpatient E/M codes (99201-99215); however, they will significantly alter documentation of the patient visit. These changes will remove the history and exam as key components, and base code-level selection on either Medical Decision Making (MDM) or time. Also, the proposed increase in RVU value will create a financial boost.“In my twenty-two years of auditing and educating physicians, it’s exciting to present good news for a change. While the set up will take thoughtful preparation, the result will be positive for both providers and administration,” says Jeannie Cagle, RN, CPC, Senior Manager of Coker Group’s coding team.

To help our clients best prepare for these changes, Coker Group is offering either a turn-key solution or a customized approach based on each client’s individual needs. Our extensive coding team, including certified professional coders and RNs, will complete these services with our in-house coding and compliance senior vice president, Roz Cordini, JD, MSN, RN, CHC, CHPC, overseeing Coker’s coding team.

The components of these services include:

  • Assessment of education and training needs for both providers and in-house coders
  • Discussion with EMR template managers to determine internal policies for new requirements and necessary template revisions
  • Development of a go-forward audit plan for provider documentation and coding audits
  • 2021 follow-up education and audits

Coker Group stands prepared to assist our clients on a customized basis to meet their needs, and it would be an honor to help you and your organization prepare for this seismic shift in E/M coding.

Contact us today and use promo code EM2021 to receive a free checklist to assess the training needs for your healthcare providers and staff.

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