AMA Releases 2021 Overhaul of E/M Service Codes

Kerry Dooley Young

September 01, 2020

The largest US physician group on Tuesday released what it described as the first major overhaul in more than 25 years of billing codes used for many office visits.

In a statement, the American Medical Association (AMA) announced the publication of the 2021 Current Procedural Terminology (CPT®) code set. AMA said the changes are intended to make coding and documentation easier for evaluation and management services (E/M). The 2021 changes should free physicians and other clinicians from "irrelevant administrative burdens that led to time-wasting note bloat and box checking," AMA explained.

AMA said the changes to CPT codes ranging from 99201-99215 are proposed for adoption by the Centers for Medicare & Medicaid Services on January 1, 2021.

Among the 2021 changes for E/M office visits are:

  • Eliminating history and physical exam as elements for code selection.

  • Allowing physicians to choose the best patient care by permitting code level selection based on medical decision-making (MDM) or total time.

  • Promoting consistency with more detail added to CPT code descriptors and guidelines.

AMA said it offers many online resources for the transition to the revised E/M codes, including a checklist, videos, modules, and guidebooks.

These revised E/M office visit codes are among 329 editorial changes in the 2021 CPT code set, including 206 new codes, 54 deletions, and 69 revisions.

The 2021 changes also include new medical testing services sparked by the public health response to the COVID-19 pandemic. Other revisions reflect changes in digital medical services, such as new codes for retinal imaging and external extended ECG monitoring, according to the statement.

"The addition of code 92229 for retinal imaging with automated point-of-care, and revision of codes 92227 and 92228, better support the screening of patients for diabetic retinopathy and increase early detection and incorporation of findings into diabetes care," the AMA said.

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