Excerpted from page 42 of the January/February 2021 edition of AOA Focus.
By now, all doctors of optometry should be reporting evaluation and management (E/M) codes in accordance with coding changes that went into effect on Jan. 1, 2021. As a reminder, on Jan. 1, the following changes went into effect:
- CPT 99201 has been deleted.
- You can choose the E/M visit level based on either medical decision-making or time.
- The revised code descriptors require history and physical exam performance to the extent medically necessary and clinically appropriate; history and exam are no longer considered key components for level selection.
- Ranges for total time (face-to-face and non-face-to-face) expended by the billing clinician in caring for a patient on the date of the patient’s office visit are given for each code, replacing the typical face-to-face times previously provided. Please note time does not include staff time, which is accounted for with practice expense.
Helpful coding resources
If you have questions regarding these code changes, please contact the AOA’s Coding Experts.
View changes to the office visit codes.
AOA Coding Today is an online, comprehensive database that contains information in real time for CPT, ICD-10 and HCPCS coding and research. AOA Coding Today is tailored specifically to optometry and assists doctors and staff in correct reimbursement and compliance with an easy-to-use code diagnosis ability based on region.
Ask the coding experts
The AOA Ethics and Values Committee releases topical and timely case study on coding abuse and what to do about it once suspected.
Evaluation and management (E/M) services are incredibly important in patient care, and it’s critical that optometry practices are aware of changes ahead. Meanwhile, the AOA and other leading physician organizations are pushing legislation that would halt Medicare payment cuts resulting from the changes.