January 5, 2023
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Disclosure:
Helio could not verify related financial disclosures at the time of issuance.
The AMA’s CPT update went into effect on January 1st. According to the organization, the update “frees physicians and care teams from time-consuming administrative tasks that are clinically irrelevant to providing quality care to patients.”
The CPT update includes 225 new codes, 93 revisions, and 75 deletions. This includes changes that affect primary care physicians who provide assessment and management (E/M) services in hospitals, homes, and nursing homes.
“This rule could help in the sense that it would create a more uniform set of coding and documentation guidelines for the services most frequently reported by family physicians.” Tochi IrokumalizeMD, MPH, MBA, FAAFP, The president of the American College of Family Medicine told Healio. “Theoretically, the changes should help by simplifying the coding of these E/M services.”
For example, Iroku-Malize says, “There will be one code set for inpatient and observational care services, rather than separate code sets.”
According to Iroku-Malize, the same uniform structure applies to home visits and home visit home or residency codes, allowing doctors to focus on medical decisions instead of worrying about medical history and tests. will be
She further noted that primary care physicians may be impacted by changes in the corresponding relative value of the code based on the Medicare physician tariff. of Medicare benefits. ”
Update impacts more physician groups
The widespread effect of the update is one of the most significant changes it brings. Talk to Helio mark SynovecMD, FACP, The Chair of the AMA’s CPT Editorial Board said this update is a continuation of the CPT E/M coding changes initiated by the CPT E/M Workgroup in 2018, with a focus on the level of medical decision-making. pointed out that there is
“The biggest change we have introduced in 2023 is to expand the E/M change to affect additional sites of service and affect additional physician specialties,” he said. “Previously, we focused our work on the E/M space to address clinic-based (“ambulatory”) services. We are currently working on other service locations. In 2023, the outpatient coding structure will be expanded to affect ED physicians, hospitalists, and physicians providing his E/M services in nursing facilities. ”
Synovec notes that the intuitiveness of updates is a major benefit for physicians.
“Rather than a series of checkboxes dictating the level of E/M CPT code assignment, providers can now direct coding to appropriate patient care based on medical decisions.” he said. “Coding should become more intuitive to the services provided and eliminate the need to provide/document unrelated services to justify proper code assignment.”
New code could help reduce workload, burnout
Synovec stresses that healthcare workers are in a difficult position due to staffing shortages and supply chain issues amid the COVID-19 pandemic, and that the CPT update will not completely solve physician burnout. No, but it could help doctors have one less obligation to worry about. almost.
“We hope we are headed in that direction. This is in line with what CMS says is making it easier for doctors and other providers to get paid by minimizing administrative hassles. It really matches,” he said.
Since the update builds on previous iterations, Synovec says implementation should be an easier transition due to the learning curve, especially for physicians practicing in both clinic and hospital settings. . Still, he said the learning curve might not be the same for some doctors, especially without the outpatient component he provides E/M services and without group members with recent outpatient coding experience. pointed out.
“I think one thing in general is that hospitalists are often employed in hospitals and large groups,” Sinovec said. “So I think it will probably be easier for them to convert because they are likely to have more administrative support. should be very similar.”
Both Synovec and Iroku-Malize encouraged physicians to review CPT guidelines and modify electronic medical record templates.
