2021 EM Changes

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nynydoc

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Can any physiatrists here comment on these changes and documentation?

I generally have been billing level 4 visits for medication management and if recommending injections. This includes image review, documentation reviews etc and these are all documented. Straight forward rehab visits are level 3 sometimes 2.

I wanted to know how some of you have been billing and possibly changing your practice with the new changes taking effect.

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Overall, I’m similar to you current billing, except I don’t recall ever billing a -02. We just had a meeting with our billers, and it actually seems to be easier to bill a -04 with the new rules. More weight is in medical decision making and you don’t need to document irrelevant ROS and exam to get to a -04. However, billing for time is a bit less favorable in the new system.
 
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Looks like the same topic is happening on the pain threads but I definitely agree with you.
Head over to some primary forums and they are arguing over 3 vs up billing to 4. They easily see more chronic conditions to justify a 4.

I’m so happy to stop documenting unnecessary family history review of systems (that can sometimes be used against us for litigations) etc and focus on AP- imaging reviewed, meds, interventions. Hopefully it will streamline clinic so much for us.
 
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