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2023 E/M
Overview
The E/M Guidelines for ED practices are changing January 1, 2023 and may have a significant impact on practice revenue if clinicians do not adapt their documentation to meet the new guidelines.
The following are the key changes with the 2023 E/M Guidelines:
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Medical Decision Making (MDM) is the sole determinant of the E/M level of service. It is essential clinicians fully document your medical decision making processes in assessing and treating a patient.
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History and/or Physical Examination (H&P) is no longer a factor in determining the E/M level of service.
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H&P must still be documented to support the problem component of MDM
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Extent of the H&P is determined by the treating physician / APP and should be medically appropriate to the individual patient
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3 Components determine the MDM Scoring (highest of 2 of 3)
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It will be more critical than ever to document what you are thinking in addition to what you are doing with these 2023 changes.
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Document your considerations of treatment even they are not performed.
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Problem - Differential diagnoses considered
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Data - Diagnostic tests appropriately considered
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Risk - Hospitalization considered; medication/treatment considered​
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Why are the E/M Guidelines changing after all these years?
According to the American Medical Association (AMA), the 2023 E/M Guidelines are intended for face-to-face interaction with the patient and to simplify coding and documentation requirements for health care providers and improve patient health under the following five principles:
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Align CPT and CMS guidelines whenever possible
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Decrease administrative burden of documentation and coding
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Decrease the need for audits
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Decrease documentation in the medical record that is not needed for patient care
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Ensure that payment for E/M is resource-based and that there is no direct goal for payment redistribution between specialties
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Below are the CPT Codes for the E/M Services provided in the ED.
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More Resources
What's Changing?
Think in Ink!
Documentation Best Practices
Videos on Common Encounters
2023 MDM Scoring
Additional Topics