Coding and Billing

99000 E/M Coding: Details on the Big Changes Coming Jan. 1

By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD

Nov. 4, 2020

Jan. 1, 2021, brings big changes to E/M coding. The new changes make coding office encounters easier. Here are the changes in a nutshell.

• The E/M code is chosen on the level of medical decision making or total time.

• Patient history and exam elements still need to be documented.

• Code 99201 is deleted.

• The definition of time associated with E/M levels 99202-99215 changes from “face-to-face” time to “total time spent on the date of the encounter.”

• “Number of diagnoses or management options” changes to “Number and complexity of problems addressed.”

• “Amount and/or complexity of data to be reviewed” changes to “Amount and/or complexity of data to be reviewed and analyzed.”

• “Risk of complications and/or morbidity or mortality” changes to “Risk of complications and/or morbidity or mortality of patient management.”

The new 99000 E/M code definitions are:

Here is the Medical Decision Making chart:

To dig deeper on this topic, go to the AMA’s entire, original document on these coding changes by clicking HERE.

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