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Preparing for the 2023 E&M Changes

AMA recent announcement.

July 2022

The AMA has recently announced that the Evaluation and Management (E&M) codes will be changing in 2023. CBIZ will provide guidance throughout the year on how these changes will affect coding protocols and reimbursement.  

Changes to the Introductory Guidelines for the following code sets may impact how your organization currently documents for services provided: Initial Inpatient Care (99221-99223); Subsequent Hospital Care (99231-99233); Consultations (99241-99255); Emergency Department Services (99281-99285); Nursing Facility Codes (99304-99310, 99315, 99316); and Home or Residence Services (99341, 99342, 99344, 99345, 99347-99350).

Additionally, the following codes will be deleted and could impact revenue: Hospital Observation Services E&M codes 99217-99220; Consultations E&M codes 99241 and 99251; Nursing Facility Services E&M code 99318; Domiciliary, Rest Home (e.g., Boarding Home), or Custodial Care Services E&M codes 99324-99238, 99334-99337, 99339, 99340; Home or Residence Services E&M code 99343; Prolonged Services E&M codes 99354-99357.

To begin your organization’s preparation, CBIZ suggests implementing the following steps in calendar year 2022:

Review E&M Charts, Focusing on Medical Decision Making (MDM) Documentation

The new E&M regulations will contain different standards for how to document medical decision making.   A baseline chart review should be performed by experts that will evaluate existing MDM documentation and identify potential gaps that exist between the current documentation and what will be needed for the new 2023 E&M guidelines.

Provide Education

Education of physicians, hospital management and other related clinicians on the new E&M regulations will be pivotal for your organization to ensure an effective transition to the new documentation rules.  Your education program should focus on the key drivers of reimbursement under the new regulations, including medical decision making and time-based reimbursement.

Click here to download the guidelines .

For any questions or for information on how CBIZ can assist during this transition period, please contact our office at 800-957-6900 or email at [email protected]

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