Guidelines delayed
June 1, 1998 2 minutes read
Guidelines delayed
Continued from front page
Some physicians and coders have interpreted reports of an "indefinite delay" in implementing the 1997 E/M guidelines to mean that the overall effort to revamp evaluation and management coding protocols has been permanently halted.
But in fact, HCFA and the AMA's goal is to have a new set of revised guidelines ready for pilot testing by this fall, with final implementation targeted for sometime between July 1999 and Jan. 1, 2000.
However, this does not mean the campaign to completely deep-six the 1997 proposal is over. Jane Orient, MD, executive director of the Association of American Physicians and Surgeons, has announced her organization's plans to sue to have the proposed rules declared illegal, saying these medical documentation guidelines will only turn doctors into "scribes for the government and insurance industry."
Certain specialties may find it to their advantage to continue using the 1997 guidelines. (See related story on p. 94 for information on how practices may use either the 1997 or 1995 codes to justify coding decisions.)
The revised 1997 E/M guidelines were originally developed in response to specialist complaints that existing coding tools did not allow them to accurately document their evaluation and management write-ups.
Because this is the case, specialists, "especially those in ophthalmology, ENT, neurology, psychiatry, and dermatology, may find the 1997 guidelines more suitable to their needs than the 1995 version since it is more tailored to these specialties," says Catherine Fischer, a reimbursement policy adviser for the 600-physician Marshfield (WI) Clinic and a member of Physician's Payment Update's editorial advisory board.
New guidelines based on 1997 version
Also, "while many of the specifics will be different, the general philosophical framework and decision-making process of the next set of revised guidelines will be basically the same as the 1997 version," notes Fischer.
In turn, physicians choosing to continue using the 1995 guidelines "run a risk of being left behind on the learning curve because the forthcoming redesign is slated to be a version of the 1997 guidelines," says Fischer.
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