Overlooked Codes Physicians Should Consider

It’s a common complaint heard among primary care physicians: Evaluation and management (E/M) codes don’t adequately capture the time, skill, and resources necessary to plan and coordinate care for patients with complex medical needs. Although new, streamlined E/M guidelines for 2021 may help, several existing remedies can enable physicians to capture additional revenue for the services they provide. 

More specifically, the U.S. Government Accountability Office (GAO) recently published a list of 58 CPT codes that fall under the category of “longitudinal comprehensive care planning” (LCCP) for Medicare beneficiaries diagnosed with a serious or life-threatening illness. These codes include elements of shared decision-making through interdisciplinary care as well as development of a care plan to address the following: 

• Progression of the disease and treatment options 
• Beneficiary’s goals, values, and preferences 
• Resources and social supports that can mitigate the beneficiary’s health risks
  
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