Office/Outpatient Evaluation And Management (E/M) Code Changes For 2021: Quick Reference Guide-Office/Outpatient Evaluation And Management (E/M) Code Changes For 2021: Quick Reference Guide

Office/Outpatient Evaluation And Management (E/M) Code Changes For 2021: Quick Reference Guide

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This Quick Reference Guide provides an overview of the changes to office/outpatient Evaluation and Management (E/M) codes for 2021. Here are the key points:<br /><br />1. History and Physical are no longer used to select an appropriate E/M code.<br /><br />2. E/M code 99201 has been deleted.<br /><br />3. E/M codes will now be selected based on Total time or Medical Decision Making (MDM).<br /><br />4. Two new add-on codes have been added:<br />   - G2211: This code has been delayed until 2024 and is for visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition.<br />   - G2212: This code is for prolonged office or other outpatient evaluation and management services beyond the maximum required time of the primary procedure. It can be used in addition to CPT codes 99205 and 99215.<br /><br />5. E/M codes will now be based on total time spent on the date of the encounter. The time ranges for each code are as follows:<br /><br />   - 99202: 15-29 minutes<br />   - 99203: 30-44 minutes<br />   - 99204: 45-59 minutes<br />   - 99205: 60-74 minutes<br />   - 99211: May not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal<br />   - 99212: 10-19 minutes<br />   - 99213: 20-29 minutes<br />   - 99214: 30-39 minutes<br />   - 99215: 40-54 minutes<br /><br />6. The Medical Decision Making (MDM) elements have been updated. The MDM levels are categorized based on the number and complexity of problems addressed, the amount and/or complexity of data to be reviewed and analyzed, and the risk of complications and/or morbidity or mortality of patient management.<br /><br />This Quick Reference Guide provides a summary of the key changes to office/outpatient E/M codes for 2021. It is important to refer to the complete documentation for detailed information and guidelines when selecting the appropriate E/M code for coding and billing purposes.

Keywords

E/M codes

2021

Total time

Medical Decision Making

add-on codes

G2211

G2212

prolonged office

CPT codes

Medical Decision Making elements