Brent Moody, MD: The Implications of E/M Code Changes for Dermatology Care

In recent years, the conversations regarding coding guidelines from the Centers for Medicare and Medicaid Services (CMS) have been complex and occasionally frustrating.

Significant changes to evaluation and management codes (E/M) were made in the beginning of 2021, along with the first major overhaul in the Current Procedural Terminology (CPT) code in 25 years, prompting further discussion among providers regarding billing documentation.

In this episode of Derm Discussions, Brent Moody, MD, Nashville Dermatology Society, and the American College of Mohs Surgery, spoke to Dr. Brad Glick of the changes made to the E/M codes, as well as the long-term effects on billing.

“There's increased value for the E/M services, and that was done as a desire to reward cognitive work, not just in dermatology, but across all specialties,” Moody said. “It also made it a little bit easier, particularly for dermatologists to bill at higher levels, because the old paradigm of counting bullets…that went away, and it really boils down to medical decision making. So for some instances, it is easier to build at higher levels. Although as we learned at some areas, it's harder.”

He added that in some instances such as a full skin check, it is more difficult for providers to bill at a higher level due to changes made in the E/M codes, prompting Moody to suggest better guidance for providers on how to properly code for common clinical scenarios, in addition to consistency across different carriers.

“We can have different rules for every different insurance company, it's too confusing,” Moody said. “And CPT and CMS, they're the gold standard, we should all follow that one standard. So, it is a problem when carriers start to deviate from what CMS wants to do.”

To hear more from Dr. Moody, listen to the latest episode of Derm Discussions above.