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AMA Issues Checklist for the Transition to E/M Office Visit Changes

The American Medical Association (AMA) is helping physician practices integrate fundamental changes to the coding and documentation of evaluation and management (E/M) office visit services that account for nearly $23 billion in Medicare spending. New Medicare office-visit coding and documentation guidelines are simpler and more flexible, but physician practices will need to prepare in the new year to get the full benefit of the burden relief the changes are designed to bring.

The AMA worked with the Centers for Medicare & Medicaid Services (CMS) and convened specialty societies and other health professionals to simplify the requirements, make them clinically relevant, and reduce excessive documentation burden. Key elements of the E/M office visit overhaul include the following: 

"These foundational changes are intended to reduce documentation burden and provide physicians more time with patients, not paperwork, says AMA President Patrice A. Harris, MD, MA. “There’s a lot to understand and to prepare for before the new guidelines take effect January 1, 2021. The AMA is helping physician practices to start planning now and offers resources to anticipate the operational, infrastructural, and administrative workflow adjustments that will result from this overhaul.” 

The following 10-point AMA checklist and linked resources will help guide physician practices for a smooth transition to the simpler and more flexible guidelines:

  1. Identify a project lead
  2. Schedule team preparation time
  3. Update practice protocols
  4. Consider coding support
  5. Be aware of medical malpractice liability
  6. Guard against fraud & abuse law infractions
  7. Update your compliance plan
  8. Check with your EHR vendor
  9. Assess financial impact
  10. Understand additional employer or payor or medical liability coverage requirements

To learn more about these significant CPT code set revisions, visit the CPT E/M webpage. Additionally, the AMA has created an interactive educational module, a detailed description of the code and guideline changes, along with a table illustrating medical decision making revision to educate physicians practices.

— Source: American Medical Association