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SGO Coding Corner | E/M Pearls: Billing on Time

Coding ToolsCoding
Feb 10, 2021

Starting Jan. 1, 2021, Evaluation and Management (E/M) codes underwent their biggest change since 1992.  Relax! You got through 2020, you will get through this. Billing on time now has well defined ranges instead of the “typical time” for prior years.  Total time for patient care includes:

  • Preparing for visit
  • Obtaining / reviewing records
  • Obtaining history / performing examination
  • Providing counseling and education
  • Ordering tests / medications / procedures
  • Independently reviewing studies
  • Communicating results
  • Coordinating care
  • Documenting

Care must be done on the date of service by the billing physician or their non-physician provider.

This year’s Virtual Coding Course will focus on coding for office encounters in 2021 including:

  • Deep dive on the new rules, documentation requirements and definitions governing office coding.
  • Clinical examples to illustrate appropriate coding for the complex patients you treat
  • How to document complexity with ICD-10 to meet the new requirements
  • Telehealth Update

For an in-depth look at the 2021 changes to E/M coding, please:
For an in-depth look at the 2021 changes to E/M coding, please:

Table: 2020 vs. 2021 Times for Billing

CPT Code 2020 2021
New Visits
99201 10 Code Deleted
99202 20 15-29
99203 30 30-44
99204 40 45-59
99205 50 60-74
Established Visits
99211 5 Time component removed
99212 10 10-19
99213 15 20-29
99214 20 30-39
99215 40 40-54

Note: all times in minutes. CPT = Common Procedural Terminology. Physician time includes the following activities: Preparing to see patient, Obtaining and/or reviewing separate obtained history, performing a medically appropriate examination and/or evaluation, counseling and educating the patient/family/caregiver. Ordering medications, tests, procedures, Referring and communicating with other health care professionals, Documenting clinical information in the electronic or other health record on the same date of the encounter. Independently interpreting results and communicating results to the patient/family/caregiver, and care coordination.