Billing and Coding with the 2021 E/M Changes - What It Means for Career Development

Psychiatrists have long existed in a medical system that at times undervalues our work, and distances us from mainstream medicine. Correctly documenting what was done for a patient, and why, are essential for the coding systems that have become indispensable to the efficient management of contemporary medical care. Physicians may find coding and billing to be indirectly related to patient care, so under or over billing is unintentionally common, with potentially significant financial consequences. CPT based billing is often converted to relative value units (RVUs) and to determine individual salary, bonuses, protected time, and service line importance. Thus, accurate coding and billing can result in increased revenue and justification for growth and development of services. “Equipping a health care workforce to accurately code medical procedures, streamlines communication across the health system, reducing administrative and rework costs at a time when resources are stretched by the COVID-19 pandemic,” said Patrice A. Harris, MD, MA, former president of the American Medical Association (AMA).

In 2021, the outpatient evaluation and management (E/M) codes were overhauled by the American Medical Association. The intent of the change was to facilitate reduction of outpatient documentation, decrease physician burnout, address the problem with copy/paste/data overload, and focus on the clinical work of the physician. This workshop will advance knowledge of these CPT coding changes from both a high level overview as well as an on-the-ground detailed perspective to help the CL psychiatrist understand the business aspect of medical practice key to successful career development. Up to date information about upcoming CPT changes and reimbursement trends will be discussed to keep the CL Psychiatric community well informed and poised for the future.

Dr. Junji Takeshita will discuss basic E/M coding and attestation of work with resident trainees as well as medical students. Dr. Sarah Parsons will further elaborate upon these concepts.. Dr. Heather Huang will discuss high complexity encounters. She will highlight how to conceptualize and recognize high complexity encounters based on psychiatric, medical, and interacting medical/psychiatric comorbidities. In addition, she will discuss appropriate documentation of those encounters. Dr James Kimball will engage participants in a multiple choice quiz to reinforce knowledge learned during the workshop.