AMA announces technical corrections to the E/M coding guidelines for outpatient visits

The American Medical Association’s (AMA) CPT Editorial Panel at its February meeting approved technical corrections to the E/M coding guidelines for outpatient visits. The corrections were uploaded to AMA website on March 9 and go into effect retroactively from January 1.

Since the updated E/M guidelines for office or other outpatient (CPT codes 99202-99215) and prolonged services (CPT codes 99354, 99355, 99356, 99417) were implemented in January, the AMA has received a lot of feedback from providers on areas of confusion. In an effort to abate confusion, AMA’s CPT Editorial Panel has made the following changes to the guidelines:

• Addition of a definition for “analyzed” as it is used in Table 2 of the guidelines (Levels of Medical Decision-Making)
• Addition of definitions for major and minor surgeries
• Clarification of activities that may not be counted when using time as a key criterion for code level selection
• Clarification of documentation for a test that is considered but not performed after shared decision-making
• Clarification of what constitutes unique testing
• Clarification of what is meant by “discussion” between qualified healthcare professionals and patients

Additional updates to this E/M guidelines may be made as issues surface that require clarification. For more information on the changes, see the AMA’s CPT Errata & technical corrections page.