Radiology Coding Alert

Reader Question:

Base These 2021 E/M Services 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?
New Jersey Subscriber

Answer: Yes, 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 and report the respective code with an aligning typical time estimate.