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Updates to E/M Documentation and Coding

Posted 6 months ago by Cameron Duncan

Good morning NAPNA members-

Efforts to simplify evaluation and management (E/M) coding, including stipulations in the 2019 Medicare Physician Fee Schedule (MPFS) rule, have driven a set of changes that will go into effect on January 1, 2021. These are major changes, and we want to assure you will be ready when they take effect.

What’s changing?

The Centers for Medicare and Medicaid Services (CMS) has finalized plans to eliminate History and Physical as components of code selection, as well as allowing providers to choose whether the documentation is based on Total Time or Medical Decision Making (MDM), and modifying the criteria for MDM. The American Academy of Professional Coders (AAPC) has compiled a great review of what’s changing in 2021, which you can find here. The changes aim to reduce administrative burden, improve payment accuracy, and update codesets to better reflect current medical practice.

I think these changes are going to be beneficial for all of us in reducing some of the documentation burdens. I hope you all find this information helpful. 

Dr. Cameron Duncan DNP, MS, APRN, FNP-C, PMHNP-BC
Vice President
Nevada Advanced Practice Nurses Association