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Family Practice Coding Alert

E/M Guideline Revisions Suspended

Eagerly awaited modifications to E/M documentation guidelines have been postponed while the Department of Health and Human Services (HHS) re-evaluates its efforts to simplify the process, according to HHS Secretary Tommy Thompson.
Proposed changes to current guidelines (1995 and 1997 versions), used to bill Medicare and other insurers, were announced in June 2000. Since then, an independent contractor had been hired to develop clinical vignettes to better define the modifications, with implementation of the new system anticipated early in 2002. During testimony before the House Ways and Means Committee on July 19, Thompson suspended further work on the new guidelines. He noted that although the 2000 version of the guidelines was intended to reduce documentation burdens, physicians say the modifications hindered appropriate patient care.

Family Physicians Welcome Reassessment  
"The American Academy of Family Physicians (AAFP) has had ongoing concerns about the guidelines in general and the clinical examples in particular," says Kent Moore, manager of Health Care Financing and Delivery Systems for the AAFP. "The HHS decision to step back and reassess the situation is welcome news." Specific concerns have revolved around greater stringency in documenting the history and medical decision-making components of an E/M service, he says, and skepticism about how applicable the clinical vignettes would be to the many different scenarios that occur during an outpatient visit.
No time line for the new round of changes has been announced, and family practices should continue to use the 1995 and 1997 documentation guidelines.