Cracking the Code

AMA Announces the Evaluation and Management Changes for 2023

2023 Summary of Revisions to the E/M Code Descriptors and Guidelines Effective January 1, 2023

Inpatient and observation care services

  • Deletion of observation CPT codes (99217-99220, 99224-99226) and merged into the existing hospital care CPT codes (99221-99223, 99221-99233, 99238-99239).
  • Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.

Consultations

  • Deletion of confusing guidelines, including the definition of “transfer of care.”
  • Deletion of lowest level office (99241) and inpatient (99251) consultation codes to align with four levels of MDM.

Emergency department services

  • Maintained the existing principle that time cannot be used as a key criterion for code level selection.
  • Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.

Nursing facility services

  • Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.
  • Revision to nursing facility guidelines with new definition of “multiple morbidities requiring intensive management,” to be considered at the high-level MDM for initial nursing facility care.
  • Deletion of code 99318 (annual nursing facility assessment). This existing service will be reported through the subsequent nursing facility care services (99307-99310).

Home and residence services

  • Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.
  • The domiciliary or rest home CPT codes (99234-99340) were deleted and merged with the existing home visit CPT codes (99341-99350).

Prolonged services

  • Deletion of direct patient contact prolonged service codes (99354-99357). These services will now be reported through either the new code, created in 2021, office prolonged service code (99417), the new inpatient or observation or nursing facility service code (993X0).
  • Creation of a new code (993X0) to be analogous to the office visit prolonged services code (99417). This new code is to be used with the inpatient or observation or nursing facility services.
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