Impact of changes in guidelines for management billing codes guidelines

Published: Thu, 03/10/22

Impact of changes in guidelines for management billing codes guidelines

Study Rundown: Time spent writing patient documentation in EHR represents a large contributor to physician workload. To reduce this burden and simplify reimbursement, the AMA enacted changes to billing code guidelines for E/M visits starting in 2021. The objective of this study was to evaluate the impact of this guideline change on physician E/M billing practices and EHR use.

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A member of a message board I follow, and to which I occasionally contribute, recently posed a question about a denial of coverage based on an alleged failure to meet medical necessity requirements. The admitting diagnosis was metabolic encephalopathy. She did not say (nor, regrettably, did I ask) the principal diagnosis submitted with the claim.

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The staff at the Centers for Medicare & Medicaid Services (CMS) have been working overtime for the last two years. I have noted before their amazing efforts during the COVID-19 public health emergency (PHE), revising and nuancing the regulations to allow medical care to continue to be provided to patients. But at the same time...

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