Say goodbye to per-day observation codes. 2023 is just around the corner, and so are updates to evaluation and management (E/M) codes. The American Medical Association (AMA) has announced the coming changes, and there are some big revisions to consider! The skinny: As with office/outpatient E/M codes in 2021, the AMA is changing descriptors for (or outright deleting) several code ranges in the other E/M subsections of CPT®. In some cases, these changes mirror what the AMA did in 2021; but there are some differences. “Overall, the CPT® Editorial Panel worked to, again, create revisions to the E/M code descriptors and guidelines that met their objective to decrease the administrative burden of excessive documentation whenever possible,” says Mary I. Falbo, MBA, CPC, CEO of Millennium Healthcare Consulting Inc. in Lansdale, Pennsylvania. Read on to see what E/M coding changes you’ll have to observe when CPT® 2023 takes effect Jan. 1, 2023. Goodbye Original Per-Day Observation Codes In one stroke, CPT® is getting rid of its per-day observation codes. What’s being deleted? CPT® 2023 will delete the following codes: What should I do? CPT® 2023 will include the following coding directive: In addition to the above deletions, CPT® also rids itself of 99217 (Observation care discharge day management…) in 2023. According to CPT®, “99217 has been deleted. To report observation care discharge services, see 99238, 99239.” Look for Discharge Services Under 99238, 99239 Reporting discharge services will be different next year, as CPT® created descriptors that will allow for one set of codes to be used for hospital inpatient or observation discharge day management. What’s being changed? CPT® 2023 will revise the descriptors for the following codes: What’s being added? CPT® 2023 will change to these descriptors for the above-listed codes: Impact: CPT® is putting hospital inpatient or observation discharge day management services into the same code descriptors. You’ll use 99238 and 99239 for both these types of discharges. Watch for CPT® Overhaul of Observation Section CPT® 2023 will retain its original initial per-day hospital care codes, but they will be vastly different and more inclusive of observation services. What’s being changed? CPT® 2023 will revise the descriptors for the following codes: What’s being added? CPT® 2023 will change to these descriptors for the above-listed codes: Impact: As the descriptors indicate, you will use 99221 through 99223 for all your multi-day hospital inpatient or observation services. For these services, you will choose from the revised 99238 or 99239 codes for discharge. As with most of the 2023 E/M changes, Falbo says these changes should make things easier for coders and providers, “since there will be consistency in both outpatient and inpatient, where MDM [medical decision making] and time are the key factors.” There will also be “less administrative burden on meeting specific requirements for history and exam,” she says. Prepare for Single-Day Observation/Inpatient Service Combo Codes CPT® 2023 will hold onto its single-day observation codes, but they will be much different. Much like the revisions of 99221 through 99223, these revisions will make the codes more inclusive. What’s being changed? CPT® 2023 will revise the descriptors for the following codes: What’s being added? CPT® 2023 will change to these descriptors for the above-listed codes: Impact: As the descriptors indicate, 99234-99236 will be your one-stop shop for one-day hospital inpatient or observation care services. Notice MDM Focus in ED Code Descriptors The 2023 E/M revisions will also hit reset on the code descriptors for emergency department (ED) E/M services. What’s being changed? CPT® 2023 will revise the descriptors for the following codes: What’s being added? CPT® 2023 will change to these descriptors for the above-listed codes: Bottom line: E/M coding in the ED just underwent a seismic shift. Rather than focus on the “three key components” that used to govern ED E/M code choice, coders will have to use MDM as the sole determinant of code level in 2023 and beyond.