The 95 & 97 guidelines for E/M are no longer used for 2023.
- The most significant revision to the 2023 E/M guidelines is the elimination of history and physical exam as elements for ED E/M code selection. Beginning in 2023, the ED E/M services will be based only on medical decision making (MDM).
- It is important to note that while history and exam will no longer directly contribute to selecting the E/M code, the ED E/M codes stipulate that there should be a medically appropriate history and/or physical examination.
Levels of E/M Services◄
Select the appropriate level of E/M services based on the following:
1. The level of the MDM as defined for each service, or
2. The total time for E/M services performed on the date of the encounter.
►Within each category or subcategory of E/M service based on MDM or time, there are three to
five levels of E/M services available for reporting purposes. Levels of E/M services are not
interchangeable among the different categories or subcategories of service. For example, the first
level of E/M services in the subcategory of office visit, new patient, does not have the same
definition as the first level of E/M services in the subcategory of office visit, established patient.
Each level of E/M services may be used by all physicians or other qualified health care
professionals.◄
What’s Changing for E/M Codes 99201-99215 in 2021? https://www.aapc.com/evaluation-management/em-codes-changes-2021.aspx#:~:text=The%202021%20guidelines%20also%20take,the%20risk%20of%20complications%20and%2F
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Our Free E&M Audit Tools will help you code in various settings such as office, hospital, facility or home. Download it today!
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