September 2001 • Volume 7 • Number 9
E/M documentation guidelines
HHS Secretary Tommy Thompson promises a fresh startBY SHERI PORTER
It's too early to celebrate, but relief could be in sight for physicians who struggle daily with Medicare billing procedures tied to coding and the evaluation and management documentation guidelines.
In a statement made July 19 before the House Ways and Means Committee, HHS Secretary Tommy Thompson said he's taking a new approach to the development of EMDGs. The controversial guidelines have created havoc in physicians' offices.
"We know that the physicians' primary work is to provide clinical care, not documentation," said Thompson. "Physicians found the first two sets of guidelines, developed in 1995 and 1997, cumbersome." The latest attempt to improve the EMDGs included the development of clinical examples, "but physicians have continued to express concern that these guidelines are hindering, not helping, the delivery of appropriate patient care," said Thompson.
Those physician concerns led to a stop-work order from Thompson: "I have directed Aspen Systems Corp. to stop their work on this current draft while we reassess and retune our effort," he said.
The AAFP has stayed on top of the issue by providing feedback to CMS. In June, the Academy joined other medical specialty societies in signing onto a letter to CMS Administrator Thomas Scully, urging CMS to "re-examine its commitment to imposing burdensome documentation guidelines and clinical examples on physicians billing for E/M services."
On the same day, the Academy sent a letter to Aspen Systems Corp. commending the company for its effort to develop relevant clinical examples, while pointing out the irony: The fact that explanatory vignettes are needed at all "is as much an indictment of the EMDGs as it is a compliment to the clinical examples," said the letter.
At press time, CMS had not released a plan of action for its reassessment process, but in his July 19 address to the committee, Thompson indicated a desire to re-examine the billing codes. "For the system to work, the codes for billing these visits need to be simple and unambiguous," he said. Thompson also repeated his commitment to utilize the physician community "to help design constructive solutions."
AAFP Executive Vice President Douglas Henley, M.D., welcomed the news from Thompson. "Years of effort have gone into trying to develop adequate documentation guidelines, without significant progress," he said. "The Academy will do whatever it can to help CMS redirect its efforts toward creating workable documentation guidelines that do not interfere with the important interaction between family physicians and their patients."
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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