AMA releases latest CPT updates to align with Medicare E/M changes, digital innovation
The American Medical Association (AMA) released updates to its medical codes for 2021 designed to align with a Medicare rule set to take effect in January.
Last year, the AMA worked with the Centers for Medicare and Medicaid Services (CMS) to modify evaluation and management (E/M) office/outpatient visit code changes, which marked the first overhaul of E/M office visit documentation and coding in more than 25 years.
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The updates to medicine’s common language aim to reduce documentation requirements for clinicians and free physicians and care teams from clinically irrelevant administrative burdens that led to time-wasting note bloat and box checking, according to the AMA.
The updates also reflect COVID-19 testing and tech-enabled medical services.
The changes in CPT codes include:
- Eliminating history and physical exam as elements for code selection
- Allowing physicians to choose the best patient care by permitting code level selection based on medical decision-making (MDM) or total time.
- Promoting payer consistency with more detail added to CPT code descriptors and guidelines.
“To get the full benefit of the burden relief from the E/M office visit changes, health care organizations need to understand and be ready to use the revised CPT codes and guidelines by Jan. 1, 2021,” said AMA President Susan R. Bailey, M.D. in a statement.
“The AMA is helping physicians and health care organizations prepare now for the transition and offers authoritative resources to anticipate the operational, infrastructural and administrative workflow adjustments that will result from the pending transition.”
The revised E/M office visit codes are among 329 editorial changes in the 2021 CPT code set, including 206 new codes, 54 deletions, 69 revisions. The CPT code set continues to see growth in new and novel areas of medicine, with the majority (63%) of new codes this year involving new technology services described in Category III CPT codes and the continued expansion of the Proprietary Laboratory Analyses (PLA) section of the CPT code set.
Among this year’s important additions to the CPT code set are new medical testing services sparked by the public health response to the COVID-19 pandemic. The CPT code set has been modified with several code additions and revisions that have been approved for immediate use and published for the 2021 CPT code set.
The CPT code set also continues to be modified to respond to the fast pace of innovation among digital medicine services such as new codes for retinal imaging and external extended electrocardiogram (ECG) monitoring.
The updated codes better support the screening of patients for diabetic retinopathy and increase early detection and incorporation of findings into diabetes care. Innovative solutions like the augmented intelligence technology described by new code 92229 have the potential to improve access for at-risk patient populations by bringing retinal imaging capabilities into the primary care setting, according to the AMA.
The organization also offers an insider’s view with detailed information on the new code changes.