AAOSNow – June 2021
by Sarah Wiskerchen and Michelle Abraham
Since the adoption of the CPT® Evaluation and Management (E/M) Office or Other Outpatient guidelines changes by the American Medical Association (AMA) on Jan. 1, numerous questions have been raised regarding the ordering of tests and medical decision-making (MDM) credit.
On March 9, AMA published revisions to the guidelines to clarify several crucial points. The revisions affect both time and MDM factors in E/M level selection. Several terms were also defined with the revisions. AMA considers these changes “technical corrections.” Many physicians and specialty societies argue that the revisions are not merely technical corrections, as some of the recommendations inconsistently apply guidance of the original guidelines and greatly impact the reporting of E/M services. The guideline changes posted on the AMA website are retroactive to Jan 1, 2021. To view the complete list of the revised definitions and guidelines, see the “CPT errata & technical corrections” listed on the AMA website, as well as the previously published guideline revisions in the CPT 2021 code book.
This article will analyze certain E/M guideline revisions and their implications, as well as break down precisely how they will affect orthopaedic surgeons.