AMA offers practices help with E/M office visit code changes

The American Medical Association has released a checklist and online resources meant to assist physician practices with new Medicare office visit coding and documentation requirements.

Last month, CMS issued a final rule reducing clinician burden regarding billing and coding requirements for Evaluation and Management services, marking the first time in more than 25 years that E/M codes have been overhauled. E/M coding is the process by which physician-patient encounters are translated into five-digit Current Procedural Terminology codes, which are submitted for payment to Medicare for common office visits.

While the new Medicare E/M guidelines are simpler and more flexible, including the elimination of history and physical exam as elements for code selection, AMA contends that physician practices will need to prepare in 2020 to get the full benefit of the burden relief the changes are designed to bring.

“These foundational changes are intended to reduce documentation burden and provide physicians more time with patients, not paperwork,” said AMA President Patrice Harris, MD, in a written statement. “There’s a lot to understand and to prepare for before the new guidelines take effect Jan. 1, 2021. The AMA is helping physician practices to start planning now and offers resources to anticipate the operational, infrastructural and administrative workflow adjustments that will result from this overhaul.”

Among the AMA’s 10-point checklist is a recommendation for physician practices to communicate with their respective electronic health record vendors to “confirm their schedule for implementing these E/M office visit code changes.”

For its part, the AMA says it is “working closely with EHR vendors from across the country to make it as straightforward as possible to implement the changes in their systems.”

According to the AMA, E/M office visit services account for almost $23 billion in Medicare spending and managing this coding and billing is crucial for maintaining the productivity of physician practices.

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