decisionhealth Newsletters, Part B News - 2017 Issue 11 (November)
Substantial changes to E/M guidelines, not codes, remains focus for CMS
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Article Overview
This article examines CMS’s 2018 Medicare physician fee schedule discussion of possible changes to evaluation and management (E/M) documentation guidelines. It focuses on how CMS is rethinking the relative roles of history, exam, medical decision-making, and time, while emphasizing that the agency is not proposing a full overhaul of the E/M code set. The piece is relevant to physicians, coders, compliance staff, and practice administrators tracking documentation policy changes and future workflow impact.
Why This Topic Matters
E/M documentation drives a large portion of office and outpatient coding, so even guideline-only revisions can affect provider workflows, medical record expectations, and audit risk. Understanding the direction CMS is taking helps practices prepare without prematurely changing internal policies.
Article Sections
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2018 physician fee schedule: E/M guidelines
Introduces the CMS fee schedule discussion and frames the article’s focus on possible future changes to E/M documentation guidance.
What You Will Learn
- How CMS is approaching potential updates to E/M documentation guidance
- Which documentation elements CMS is reconsidering at a high level
- Why commenters raised concerns about the pace and scope of change
- How the discussion differs from a full code-set overhaul
Who Should Read This
- Physicians
- Medical coders
- Compliance professionals
- Practice administrators
- Revenue cycle staff
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