Starting Jan. 1, 2021, Evaluation and Management (E/M) codes underwent their biggest change since 1992. Relax! You got through 2020, you will get through this. Billing on time now has well defined ranges instead of the “typical time” for prior years. Total time for patient care includes:
- Preparing for visit
- Obtaining / reviewing records
- Obtaining history / performing examination
- Providing counseling and education
- Ordering tests / medications / procedures
- Independently reviewing studies
- Communicating results
- Coordinating care
- Documenting
Care must be done on the date of service by the billing physician or their non-physician provider.
This year’s Virtual Coding Course will focus on coding for office encounters in 2021 including:
- Deep dive on the new rules, documentation requirements and definitions governing office coding.
- Clinical examples to illustrate appropriate coding for the complex patients you treat
- How to document complexity with ICD-10 to meet the new requirements
- Telehealth Update
For an in-depth look at the 2021 changes to E/M coding, please:
For an in-depth look at the 2021 changes to E/M coding, please:
- Join us for the SGO Coding Course Friday, March 19, during the Virtual Annual Meeting on Women’s Cancer
- Enjoy the SGO webinar titled Evaluation and Management Coding Changes for 2021 on the SGO ConnectEd site.
- ACOG’s Coding site, which includes a 1 page desk reference
- The ACOG Coding site also has a table of all the times for the E/M codes
Table: 2020 vs. 2021 Times for Billing
| CPT Code | 2020 | 2021 |
| New Visits | ||
| 99201 | 10 | Code Deleted |
| 99202 | 20 | 15-29 |
| 99203 | 30 | 30-44 |
| 99204 | 40 | 45-59 |
| 99205 | 50 | 60-74 |
| Established Visits | ||
| 99211 | 5 | Time component removed |
| 99212 | 10 | 10-19 |
| 99213 | 15 | 20-29 |
| 99214 | 20 | 30-39 |
| 99215 | 40 | 40-54 |
Note: all times in minutes. CPT = Common Procedural Terminology. Physician time includes the following activities: Preparing to see patient, Obtaining and/or reviewing separate obtained history, performing a medically appropriate examination and/or evaluation, counseling and educating the patient/family/caregiver. Ordering medications, tests, procedures, Referring and communicating with other health care professionals, Documenting clinical information in the electronic or other health record on the same date of the encounter. Independently interpreting results and communicating results to the patient/family/caregiver, and care coordination.