INTRODUCTION TO 2021 OFFICE AND OTHER …

INTRODUCTION TO 2021 OFFICE AND

OTHER OUTPATIENT E/M CODES

EFFECTIVE DATE: JANUARY 1, 2021

BENJAMIN N. SHAIN, MD, PHD

AACAP COMMITTEE ON CODING AND REIMBURSEMENT

CPT is a registered trademark of the American Medical Association. Copyright 2020 American

Medical Association. All rights reserved.

QUESTIONS?

? Please contact Karen Ferguson at kferguson@ or 202-587-9670.

? Karen is our Committee staff person and will either answer your questions or pass them on to the Committee.

AGENDA

? Structure of E/M codes ? Coding based on time ? Prolonged service ? Coding based on medical decision making (MDM)

STRUCTURE OF E/M CODES

? Most E/M codes are part of a "family"

? Site of service, for example:

? Office and other outpatient

? Inpatient

? Nursing facility

? Emergency department

? Patient status, for example:

? New ? Established ? Day of discharge

? Consultation

LEVELS

? Most code families have multiple levels

? Typically 3 or 5 levels ? Level is denoted by the 5th digit of the code

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