Opinions on this article relating to 2021 e&m rules for derm

JesseL

Expert
Messages
404
Best answers
0
I just came across this article from Mdedge (see attachment) regarding 2021 new e/m rules for derms.

It says " Simplified coding and billing requirements for E/M visits will go into effect Jan. 1, 2021. For dermatology, any visit where a decision to do a minor procedure or prescribe a medication takes place will become a level 4 visit. Most of the useless documentation requirements and need to examine multiple organ systems will be eliminated. The most common E/M code currently used by dermatologists is a level 3, and this will on average move up to a level 4. Thus, general dermatology will benefit from the new rule. For example, if a dermatologist sees a patient and does a tangential biopsy of the skin, the payment will be $214.52, compared with $178.65 in 2020."

That's totally false right? The part where it says "any visit where a decision to do a minor procedure or prescribe a medication takes place will become a level 4 visit." That's only one of three of the elements (risk) of MDM not considering data or complexity of the problem. And his example suggest billing a level 4 visit with the minor procedure because "decision to perform minor procedure" is in that risk category. Which also seems false to me because minor procedures includes the E&M. Unless, I'm the one that doesn't know what I'm talking about?

Just want to hear other opinions. The link to the full article is on the link below but you'd have to register to see it (unless you use adblock I think), so I've attached the relevant page instead.

 

Attachments

  • The 2021 Medicare proposed rule_ The good, the bad, and the ugly _ MDedge Dermatology.pdf
    129.8 KB · Views: 5

thomas7331

True Blue
Messages
2,964
Best answers
7
In my opinion, and with all due respect to the writer, the article directly contradicts CMS guidance on the global surgical package and also reflects some misunderstandings of E/M coding and documentation requirements and of the rationale for the changes being implemented.

Generally speaking, the first thing I do when I read any article is to consider the news source and the credentials of the author. In this case, the article appears to be written by an MD who does not have coding credentials. Just as I'd be skeptical of medical advice from someone doesn't have clinical credentials, I'd be equally skeptical of relying on coding advice from someone who doesn't have a coding certification. Enough said?
 
Last edited:

JesseL

Expert
Messages
404
Best answers
0
In my opinion, and with all due respect to the writer, the article directly contradicts CMS guidance on the global surgical package and also reflects some misunderstandings of E/M coding and documentation requirements and of the rationale for the changes being implemented.

Generally speaking, the first thing I do when I read any article is to consider the news source and the credentials of the author. In this case, the article appears to be written by an MD who does not have coding credentials. Just as I'd be skeptical of medical advice from someone doesn't have clinical credentials, I'd be equally skeptical of relying on coding advice from someone who doesn't have a coding certification. Enough said?

You'd think mdedge is a reliable source. But this article is misleading and gives false information to other providers that do not understand coding.
 
Last edited:
Top