With the 2021 E/M Guidelines, one of the presentations stated that a new problem meant it was new to the patient, not the provider (as was in CMS 95/97). Can you confirm this is correct? As an example, a patient has been diagnosed with migraines treated by their primary care provider (PCP) but decides to get another opinion from a neurologist. Would this be a new problem to the neurologist? ...
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Article Overview
This brief article addresses a common question about 2021 E/M evaluation and management guidance and how the concept of a “new problem” is interpreted when a patient is seen by a different clinician or specialty. It is relevant to coders, auditors, and providers who work with office and outpatient E/M documentation and want to understand the general topic covered by the guidance discussion.
Why This Topic Matters
Understanding how the article frames this E/M concept helps users decide whether the premium content is relevant to documentation review, coding education, or audit preparation for office and outpatient encounters.
What You Will Learn
- The article’s focus on the 2021 E/M guidelines
- How the concept of a “new problem” is discussed in relation to prior diagnosis
- Why specialty context may matter in the question raised by the article
- The general type of clarification provided in the Q&A format
Who Should Read This
- Medical coders
- Coding auditors
- Physicians and other clinicians
- Practice managers
- Compliance staff
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