Its About Time

Posting Date:  Jan 06, 2021
Microsoft Word - It's About Time

Happy New Year! To help you celebrate 2021, the ever-confusing E/M codes have been changed! These changes will affect chiropractors a little, but they’re a BIG DEAL to medical doctors.

Basically, we’re still required to perform an appropriate history and exam. Nothing new there. Instead of worrying about what kind of history, what kind of exam and what kind of medical decision making, we’re now to select the appropriate E/M code based on either…

TIME or MEDICAL DECISION MAKING

2021 Requirements for E/M Codes 99202-99205

Code History/Exam MDM Total Minutes

99202

Medically appropriate history and/or exam

Straightforward

15-29

99203

Medically appropriate history and/or exam

Low

30-44

99204

Medically appropriate history and/or exam

Moderate

45-59

99205

Medically appropriate history and/or exam

High

60-74

In addition, they’ve eliminated CPT code 99201. Here are the basics:


2021 Requirements for E/M Codes 99211-99215

Code

History/Exam

MDM

Total Minutes

99211 A problem that may not require the presence of the physician or other qualified health care

professional, but the service is provided under the physician’s or other qualified health care professional’s supervision.

99212

Medically appropriate history and/or exam

Straightforward

10-19

99213

Medically appropriate history and/or exam

Low

20-29

99214

Medically appropriate history and/or exam

Moderate

30-39

99215

Medically appropriate history and/or exam

High

40-54

Code Based on Time (documenting time in and time out and total time is the best and safest

way to do this).

9920X/9921X – a total of x minutes spent:

  • Preparing to see the patient (e.g. review of tests)

  • Obtaining and/or reviewing separately obtained history

  • Performing a medically appropriate history and/or examination

  • Counseling and educating the patient/family/caregiver

  • Ordering tests or procedures

  • Referring and communicating with other health care professionals (when not separately reported)

  • Documenting clinical information in electronic health/medical record

  • Independently interpreting results (not separately reported) and communicating results to the patient/family/caregiver

  • Care coordination (not separately reported)


Before you see the Medical Decision Making information, I’ll cut to the chase: the vast majority of chiropractors should/will use TIME as the E/M deciding factor, NOT medical decision making. So, don’t panic.

To see the rules regarding Medical Decision Making, you can get that here: https://www.ama-assn.org/system/files/2019-06/cpt-revised-mdm-grid.pdf

Remember what I said, though. Don’t. Panic.

In my EMR, we programmed it so we just need to click on the time and if it’s a new or established patient, and the software does the rest. It selects the appropriate code for me. If I were to use medical decision making, I’d have to refer to the grid link I wrote above.

To see how I document this, you can email me at drgregg@TheBulletProofChiro.com and I’ll send you a brief video.

Be BulletProof.