AAMC Testifies on E&M Documentation
Guidelines
June 7, 2002- University of Chicago Practice Plan
Executive Director Albert Bothe Jr., M.D. testified
on behalf of the AAMC on Evaluation and Management (E&M)
Documentation Guidelines before the American Medical Association
(AMA) CPT Editorial Panel E&M Workgroup on May 17 and
before the Practicing Physicians Advisory Council (PPAC) on
June 3. The AMA is leading an effort to review E&M CPT
codes and their descriptors to identify ways to address concerns
surrounding the current codes and related HCFA documentation
guidelines.
Discussion of changes to the codes and guidelines have explored
topics including: the continued use of 5 levels of E&M
codes; the use and measurement of time, including pre and
post service time; and the relative roles and correlation
of history, physical examination and medical decision making
components. Further, the Department of Health and Human Services
Secretary's Advisory Committee on Regulatory Reform recently
announced a recommendation to eliminate E&M Documentation
Guidelines.
The AAMC statement commented on the interrelationship of
issues faced by faculty physicians who work under both the
E&M documentation guidelines and the Teaching Physician
Regulation, as well as specific issues unique to the teaching
physician setting. The need to eliminate duplication of documentation
in the teaching setting and to eliminate the current emphasis
on "counting" was highlighted. The importance of
considering new E&M coding systems in light of the increasing
use of the electronic medical record among academic medical
centers was also cited.
The AAMC, while supportive of efforts to reduce regulatory
burden on physicians, is concerned that any proposed changes
to the E&M system and documentation guidelines be agreed
upon by the Centers for Medicare and Medicaid Service (CMS)
and the Office of the Inspector General (IOG). Any revised
system should be thoroughly pilot tested by various types
of providers, including those practicing at academic medical
centers and involve carrier reviewers, CMS' Program Integrity
Group and IOG. The AAMC encourages the provision of comprehensive
educational efforts with physicians, other health professionals
and carrier staff and reviewers after adoption of any revised
or new E&M systems.
Information:
Denise Dodero, Associate Vice President
AAMC Health Care Affairs
ddodero@aamc.org
(202) 828-0493
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