National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 1 of 1 Research Studies DisplayedApathy NC, Hare AJ, Fendrich S
Early changes in billing and notes after evaluation and management guideline change.
This study investigated whether the American Medical Association updated 2021 guidance for frequently used billing codes for outpatient evaluation and management (E/M) visits changed E/M visit use, documentation length, and time spent in the electronic health record (EHR). The authors used data from 303,547 advanced practice providers and physicians across 389 organizations who use the Epic Systems EHR. Data containing weekly provider-level E/M code and EHR use metadata were extracted from the Epic Signal database for visits from September 2020 through April 2021. Following the new guidelines, level 3 visits decreased by 2.41 percentage points to 38.5% of all E/M visits, a 5.9% relative decrease from fall 2020. Level 4 visits increased by 0.89 percentage points to 40.9% of E/M visits, a 2.2% relative increase. Level 5 visits (the highest acuity level) increased by 1.85 percentage points to 10.1% of E/M visits, a 22.6% relative increase. Changes varied by specialty. No meaning changes in measures of note length or time spent in the EHR were found. The authors noted that fully realizing the intended benefits of this guideline change will require more time, facilitation, and scaling of best practices that more directly address EHR documentation practices and associated burden.
AHRQ-funded; HS026116.
Citation: Apathy NC, Hare AJ, Fendrich S .
Early changes in billing and notes after evaluation and management guideline change.
Ann Intern Med 2022 Apr;175(4):499-504. doi: 10.7326/m21-4402..
Keywords: Payment, Electronic Health Records (EHRs), Health Information Technology (HIT)