Otolaryngology Coding Alert
Know Which 2021 E/M Services Will be Based on MDM, Time
Question: Is it true that evaluation and management (E/M) coding for office and outpatient visits will be based on medical decision making (MDM) and time exclusively in 2021? New Jersey Subscriber Answer: Yes, but both will not determine the level of outpatient E/M simultaneously. Beginning in calendar year (CY) 2021, you’ll report code range 99202-99215 exclusively based on either time or MDM. The 1995/1997 evaluation and management (E/M) guidelines will still apply to the remaining E/M subsections. Keep in mind: The new guidelines on time reporting will vary slightly from the current 50 percent threshold guidelines. As of 2021, counseling and coordination of care services will not need to account for 50 percent of the visit in order to use time to determine E/M level. Rather, you’ll calculate the total amount of time spent with the patient, including non-face-face time used for prep and concluding the encounter, and report the respective code with an aligning typical time estimate. The times associated with each code and the MDM chart for 2021 has changed from what we know currently. Stay tuned for any updates on the time/code relationship.
Otolaryngology Coding Alert
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