PYA Thought Leader Quoted in Article Highlighting Potential Changes to E/M Documentation and Reporting

A recent article in DecisionHealth’s Part B News provides a glimpse into the future of charting patient encounters and the changes that will occur regarding Evaluation and Management (E/M) documentation. The 2018 Medicare Physician Fee Schedule Final Rule requests feedback and collaboration toward a new guideline or methodology that will update the currently used 1995 and 1997 documentation guidelines, which do not address the technology and clinical processes of today.

The article, “Lighting the E/M fuse: Looming guideline changes foretell a new era in reporting,” provides insight on potential E/M documentation guideline modifications that “…could mean a significant change in the way practices report — and get paid for — their most common services.” Valerie Rock, a senior consulting manager with PYA, was interviewed by Part B News and is quoted within the article. She considers the responses of the coding community from a recent conference, “If you ask those in the trenches of E/M coding, it seems that the answer is going to be a refinement of the current E/M guidelines,” she said. “However, if you look at this issue from outside of the guidelines, you might see that there are a few additional avenues for resolution.”

Obviously changing the E/M documentation structure is complex and will not occur overnight.   You should continue to monitor PYA’s publications, as well as your professional societies, for opportunities to provide input into these changes– especially when CMS releases its 2019 Medicare Physician Fee Schedule Proposed Rule with Comment Period (likely mid-summer 2018).

The quoted material above was reprinted with permission from Part B News. Subscribe to Part B News here.

If you would like more information about E/M coding, how to effectively capture your hierarchical classification of conditions (HCCs) and appropriately report risk to support accurate Risk Adjustment Factor (RAF) scores, or other compliance-related issues, contact the experts listed below at PYA, (888) 420-9876.

Valerie Rock

Valerie Rock

Senior Manager

Lori Foley

Lori Foley


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