Compare and Contrast

1997 E/M Coding Key 2021 E/M Coding Key Components

Components
These components are history; examination; Coding for office visits will be based solely
medical decision making; counseling; on medical decision making (MDM) or total time, and
coordination of care; nature of presenting the history and exam components will no longer be used
problem; and time. The first three of these (Millette,2020).
components (i.e., history, examination and
medical decision making) are the key
components in selecting the level of E/M
services (CMS,1997).

Differences:
The biggest changes in evaluation and management coding in more than two decades take effect Jan. 1, 2021.
They will allow physicians to code office visits based only on total time or medical decision making
(Millette,2020).The medical decision making coding method relies on three categories: problems (the
severity of the conditions for which you’re seeing the patient), data (what you had to review for the visit), and
risk (the patient’s morbidity or mortality odds) (Millette,2020).

Similarities:
The similarities between the E/M coding components and the 2021 E/M coding components are the medical
decision making and the use of total time for coding purposes.

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 1) Do you feel the changes will be beneficial to practice? Why or why not?
I believe the changes will help with faster and simpler patient notes
and CPT coding that is less complicated to allow for proper
reimbursement.
2) How do you believe providers will respond to the changes?
I believe providers will respond positively to the E/M coding changes
due to the fact of decreasing patient notes and allowing for easier to
understand CPT coding guidelines that focus on only medical decision
making and total time and exclude unnecessary history and exam
components.
3) Are there any perceived negatives to the new 2021 E/M coding? If so
what are they?
Perceived negatives could be the possibility that a patient encounter
can last longer than their problem E/M code suggests, which could then
effect the clinics patient flow due to extended time with a brief visit
that is actually requiring longer time than the clinic will be reimbursed
for.

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 References

CMS. (1997, January). 1997 documentation guidelines for evaluation and ... - CMS. CMS.gov.
Retrieved November 14, 2021, from https://www.cms.gov/Outreach-and-
Education/Medicare-Learning-Network-
MLN/MLNEdWebGuide/Downloads/97Docguidelines.pdf.

Millette, K. W. (2020, October 1). Countdown to the E/M coding changes. Family Practice
Management. Retrieved November 14, 2021, from
https://www.aafp.org/fpm/2020/0900/p29.html.

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