By Terri Scales, Bill Dunbar, and Associates
You will have two more years to prepare for the next wave of Evaluation and Management (E/M) changes. On January 1st, 2023, you will see dozens of changes to the codes and guidelines in the “Other” categories of E/M, according to the CPT® Editorial Summary of Panel Action February 2021. It was always the intent of the AMA and the CMS to revise the “Other” categories of E/M once the changes for the Office Visits were implemented. Not many details have been released, but we do know you can expect the following:
Inpatient and observation services
- Deletion of codes for observation discharge (99217), initial observation (99218, 99219, 99220), and subsequent observation (99224, 99225, 99226)
- Revision of codes and guidelines for initial hospital care (99221-99223), subsequent hospital care (99231-99233), admission and discharge on the same date of service (99234-99236), and hospital discharge (99238, 99239) Consultations
- Deletion of codes 99241 and 99251
- Revision of other codes and guidelines Emergency Department Services
- Revision of codes 99281-99285 and guidelines for Nursing Facility Services
- Deletion of annual nursing facility assessment code 99318
- Revision of all other codes and guidelines Domiciliary, Rest Home (e.g., Boarding Home), or Custodial Care Services, Home Services
- Revision of all codes and guidelines E/M services guidelines
- Revision of the MDM table to support changes in other categories
Until these changes go into effect in 2023, code office visits using the 2021 EM guidelines. And use the 1995 and 1997 EM documentation guidelines for all other categories. With this summary of changes published, you can expect future guidelines and revised code descriptions to be more consistent with the changes that were implemented for office visits in 2021.
