By Carol Hoppe, CPC, CCS-P, CPC-I
MedLucid Solutions

Note: An update to this story, concerning changes to ‘date entered and reviewed’, is online here. 

The 2020 Medicare Physician Fee Schedule Final Rule was published in late 2019, with revisions to the Evaluation and Management (E/M) office visit CPT® codes (99201-99215) code descriptors and documentation standards that were designed to reduce the administrative burden on physicians. These changes took effect Jan. 1, 2021. This week, the CPT Editorial Panel’s executive committee published technical corrections to clarify areas that physicians had found problematic.

The corrections, posted March 9 and effective as of Jan. 1, 2021, include clarification that “ordering a test may include those considered, but not selected after shared decision making,” for example, if the patient is high risk or the test is determined to be unnecessary. New definitions were added to clarify the following:

• The meaning of “Analyzed” for reporting tests in the data column.
• What constitutes a “Unique” test.
• What is meant by “Discussion” between providers and patients.
• Major vs. minor surgery.

Other definitions were updated for further clarification, including: “For the purposes of data reviewed and analyzed, pulse oximetry is not a test.” The AMA also clarified which activities are not counted when reporting time as a key criterion for code selection.

For additional information, see the following AMA publications:

Overview of March 9, 2021, technical corrections

Text of March 9, 2021, technical corrections

Updated guidelines in the 2020 PFS Final Rule, including March 9, 2021, technical corrections