Medical coding and billing may soon get a bit more complicated for physicians' practices across the country, according to Family Practice News. This is especially true with evaluation and management (E&M) services, a key payment aspect of Medicare. As many in the health care industry know, there have been significant increases in Medicare payments for these services, which could lead to an increased need for electronic medical billing in the future.

The AMA gets involved
According to the source, the American Medical Association is expecting a vote from their CPT editorial panel in mid-May in regards to the E&M code changes. This means that if the proposals are significant enough, the Centers for Medicare and Medicaid Services might conduct major rewrites of the coding in order to keep up with panel's decision.

Dr. Robert Wergin, the president-elect of the American Academy Physicians, actually explained to the source that re-evaluating these codes from time to time is a good thing, as health care services can change over time in this increasingly technological medical boom.

However, he warned "if the motivation is to put up a barrier to code appropriately for the level of complexity of visits, it's another step to undervalue the cognitive area," to Family Practice News. The source went on to say that health officials in the U.S. government are researching more into technologically advanced medical billing solutions, as they are easier to adapt with changes to medical coding.

Why E&M medical coding is important
According to E/M University, E&M coding is the process by which patients and doctors use CPT codes to facilitate physician services into billing. However, despite how important the use of these codes are, the site revealed that a large number of doctors don't completely understand the rules and updates of E&M coding, which dramatically underserves their practices. There are different levels of code for different types of venues (such as hospitals versus medical offices) and specific types of care (such as a returning patient versus a new patient), and doctors should definitely be aware of what kinds of E&M codes pertain to their line of work.

How Medicare coding trends are changing with E&M services
There have been two previous E&M coding guidelines that are generally used in medical practices, one released in 1995, the other in 1997 – so several in the health care community believe that some changes might be needed for the 21st century. A report released by the U.S. Department of Health and Human Services in 2012 showed that from 2001 and 2010, Medicare payments for E&M services increased from $22.7 billion to $33.5 billion – a 48 percent jump. The report also indicated that these types of charges are prone to fraud and abuse and looked into the reasons why. Ever since, the U.S. government, especially with the rollout of the Affordable Care Act, is looking for ways to reduce waste within Medicare, which could explain why a re-focus on E&M coding is making its way into the forefront.

Although it remains to be seen whether or not the U.S. government or the AMA will make the changes to E&M coding to eliminate waste and fraud within Medicare billing, practices need to be aware of these developments in the coming weeks so that their practice is prepared for an overhaul. Progressions like this affect everyone involved in health care, from the patient to your medical staff to your own services.