DON'T FALL FOR IT - 2021 E/M - Guidelines are a Trap

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e/m, E&M, E/M documentation guidelines DON'T FALL FOR IT - 2021 E/M - Guidelines are a Trap

Category: Coding

At first glance, the changes to E/M documentation guidelines for office services coming in 2021 seem like a substantial reduction in the documentation burden for providers working in the office and make it much easier to document higher level services.

But once CMS and other payers figure out the negative impact to their bottom line profits from the increased spending on level IV and V E/M services rendered in the office, expect Medical Coverage Policy and Local Coverage Determinations to possibly pre-empt the AMA's published guidance on 2021 E/M services or at least tighten the documentation requirements needed to establish the medical necessity of these services.

We keep hearing that "CMS has accepted and finalized the changes," and that is true. But here are two things to keep in mind. First, nothing is ever set in sto...

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