2023 E/M revisions warrant study to prevent denials

Oct. 14, 2022 / By Colleen Ejak, RHIA

My goal each week over the next few months is to focus in on one evaluation and management (E/M) category, taking a deeper dive into the revisions and guideline changes. In addition to the E/M category revisions, I will lay out the details of the revisions made to the elements of medical decision making and time, so you are prepared to accurately apply the revisions. 

As documentation integrity and coding professionals, our role is to ensure the E/M level of service reflects the services furnished during the visit. That includes assigning or validating the E/M codes based on provider documentation, and provider education all important links in the revenue cycle. 

The E/M categories that will undergo revision in 2023 include the following: 

  • Inpatient and observation care services 
  • Consultations – both outpatient and inpatient 
  • Emergency department services 
  • Nursing facility services 
  • Home and residence services  
  • Prolonged services 

In this installment, read about the changes to inpatient and observation care services in ICD10Monitor. 

Colleen Ejak, RHIA, CCS, CCDS-O, is a consultant with 3M Health Information Systems. 


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