Coding Background Image

Exceptional Coders | Innovative Technology

CMS Proposed Rule Reduces Evaluation and Management Coding Burden

Posted by David Fong on Aug 15, 2018 6:00:00 AM

The Centers for Medicare and Medicaid Services has released a proposed rule for the Calendar Year 2019 Physician Fee Schedule that purportedly reduces the corresponding burden of paperwork that clinicians face when billing Medicare, in order to enable them to spend more time taking care of patients. The initiative could greatly affect the time involved in using electronic health records and how clinicians interact with systems.


CMSProposedRulesPart of the agency’s Patients Over Paperwork initiative, the CMS proposal is an attempt to “get government out of the way and providers taking care of their patients” by streamlining documentation requirements and modernizing Medicare payment policies, said Administrator Seema Verma during a conference call with members of the press and reported in Health Data Management.


In particular, CMS has set its sights on reducing the burden of Evaluation and Management (E&M) codes on physicians, who are required to document specific types of information in patients’ medical charts. E&M coding is the process by which physician-patient encounters are translated into five-digit Current Procedural Terminology (CPT) codes, which are submitted to insurers for payment. 


“Evaluation and Management or E&M visits make up around 40 percent of all Medicare payments under the Physician Fee Schedule, and guidelines have not been updated since 1997—21 years ago,” according to Verma, who added that nearly 750,000 clinicians use these codes. “The requirements often mean that doctors have to cut or paste chunks of information across medical records strictly for billing purposes.”


Whether this proposed rule gets adopted or not, Aviacode can reduce your coding burden. Our advanced medical coding solution that guarantees accuracy and turnaround; is less costly and less hassle for practice managers, physicians, hospitals, health systems, providers and payers. You can use us as a temporary solution for eliminating backlogs or for providing overflow coding coverage, or as a permanent transition of specific specialties or departments.


Aviacode uses only the best credentialed and experienced coders in the industry. All our coders are AAPC- or AHIMA‑ certified and have the years of experience requested by our providers and are continually working to improve their productivity and to stay on top of all changes in rules and regulations – including these new E&M changes, through ongoing training.


Aviacode has skilled coding expertise in a number of chart types, including inpatient, outpatient, same-day surgery, emergency department, observation, ancillary, recurring, and diagnostic and interventional radiology. Our coders and auditors have deep experience from facility, pro-fee, and HCC / risk adjustment.


Public comments on the proposed rule are due by September 10, 2018.

Topics: Medical Coding, Outsourcing