The American Medical Association updated codes Tuesday for office and outpatient visits that address the COVID-19 pandemic and tech-enabled care, among other issues.
The changes to the evaluation and management office visit codes include eliminating history and physical exam elements for code selection, basing code selection on medical decisionmaking or total time, and adding more detail to code descriptions, the AMA said in a news release. The association suggested CMS adopt the changes on Jan. 1.
"To get the full benefit of the burden relief from the E/M office visit changes, healthcare organizations need to understand and be ready to use the revised CPT codes and guidelines by Jan. 1, 2021," AMA President Dr. Susan Bailey said in prepared remarks. "The AMA is helping physicians and healthcare organizations prepare now for the transition and offers authoritative resources to anticipate the operational, infrastructural and administrative workflow adjustments that will result from the pending transition."
The updates garnered mixed reviews from physicians.
The Medical Group Management Association said that they will alleviate physicians' administrative burden, streamline requirements and provide more flexibility.
While the American College of Radiology noted the commitment to reduce documentation requirements, it is unacceptable that the codes penalize thousands of physicians who do not frequently bill evaluation and management services, ACR said.
The budget-neutral reimbursement boost for evaluation and management services will result in an 11% across-the-board cut to pay for E/M codes in Medicare, which is "particularly ill-timed and harmful given the ongoing COVID-19 pandemic and its impact on all physician practices," ACR said in a statement.
The college joined more than 50 other physician and non-physician organizations in asking Congress to waive the budget neutrality requirement, ACR noted.
"An 11 percent across-the-board cut will seriously threaten radiology's ability to ensure patients have access to the high quality of care they rightfully deserve."
There are 206 new codes—most of which involve new technology services like data collection—as well as 54 deletions and 69 revisions.
Some of the additions that went into effect earlier this year address COVID-19, such as ones that facilitated payment for infectious agent detection by nucleic acid or immunoassays as well as new probe techniques used to diagnose COVID-19. New codes also enabled reimbursement for antibody testing for COVID-19, for instance.
The AMA offered some examples for new tech-enabled services for eye and heart screening. Some of the new codes aim to better screen and treat diabetic retinopathy by allowing payment for artificial intelligence technology at primary-care settings, which the association hopes will improve access for at-risk populations.
There are also new codes for algorithmic technology that works in concert with a patch used in external extended electrocardiograms. The technology provides more accurate and complete data for physician interpretation, the AMA said.
