Health Information Management

Q&A: When will we see national E/M guidelines?

APCs Insider, February 28, 2014

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Q: Are we ever going to have a set of national guidelines for E/M visits? This has been on the docket for years.
A: While CMS' intent was to create national guidelines to institute for the reporting of hospital outpatient visits, it conceded in the 2014 OPPS Final Rule on page 75038 that this is much more difficult than originally anticipated. CMS noted:
It is not feasible to adopt a set of national guidelines for reporting hospital clinic visits that can accommodate the enormous variety of patient populations and service-mix provided by hospitals of all types and sizes throughout the country. Moreover, no single approach appears to be broadly endorsed by the stakeholder community.
Editor’s note: Andrea Clark, RHIA, CCS, CPCH, chairman, CEO, and founder of Health Revenue Assurance Associates, Inc., in Plantation, Fla., answered this question.

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