Cracking the Code: A Guide to 2023 E/M Coding Updates. Co-sponsored by ACLP's Division Director's SIG and Business of C-L Psychiatry Subcommittee

Accurate documentation and coding of patient care is essential for both individual Consultation-Liaison (CL) psychiatrists and CL service lines in the current healthcare environment. Productivity and value are often determined by Current Procedural Terminology (CPT)-based billing via conversion to relative value units (RVUs). For individual psychiatrists, RVUs can determine salary, bonuses, or protected time. For service lines, RVUs can help justify retaining staff resources or strengthen proposals for expansion.
Unfortunately, evidence indicates physicians lack proficiency in this area. Professional fee coding was one of the lowest rated areas of confidence in a recent survey of CL service directors, even though demonstrating the value of their service was a high priority (Bronson 2020). Unsurprisingly, medical trainees and early career physicians report having received insufficient or inadequate billing education despite recognizing its importance to effective clinical practice (Austin 2019). CL psychiatrists in all settings, especially those in underserved, community, or rural settings, must develop and maintain proficiency in coding and billing practices to ensure that services not only remain available but have the potential to expand.
Frequent changes to medical coding are an additional barrier to obtaining and maintaining this skill. Though meant to reduce administrative burden on physicians, the 2023 CPT codes include significant changes to evaluation and management (E/M) codes for a wide range of services applicable to CL psychiatrists, including inpatient, consultation, emergency, nursing facilities, homes and residences (AMA 2023).This workshop aims to help CL psychiatrists in all career stages and practice settings improve their understanding of the 2023 changes to E/M coding requirements and the potential impact on their work.
Dr. Stephanie Cho will discuss basic concepts in E/M coding and its use by healthcare systems to determine resource allocation (5 min).
Dr. Junji Takeshita will discuss time-based coding requirements, with specific reference to changes in how time is measured (15 min).
Dr. James Kimball will discuss medical decision making (MDM) based coding requirements, with attention to changes in determination of complexity (15 min).
Dr. Andrea DeSimone will discuss coding strategies for unique circumstances including working from home, providing critical care services, or returning outpatient phone calls (10 min).
Dr. Patrick Ying will discuss tools to support accurate and appropriate billing, including demonstration of an online coding calculator (10 min).
Interactive Skills Workshop (35 min): Participants will work through E/M coding complexities in real time, using audience-sourced examples where possible. They will be provided a "cheat sheet” handout and encouraged to access and use an online coding calculator tool.
The speakers will produce a webinar as an enduring resource for the ACLP community using workshop feedback to identify content areas of greatest educational need and interest.

References:

1. Bronson B, Perlman G. (2021) J Acad Consult Liaison Psychiatry, 62(3):309-317.

2. Austin RE, von Schroeder HP. (2019) Can J Surg, 62(5):340-346.

3. AMA 2023 E/M code descriptors and guidelines. https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf