2021 Questions to AMA regarding 2021 E/M Coding Changes and Responses

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Request for clarification to AMA regarding 2021 E/M coding changes.

Full Description

Systemic Symptoms

In the definition of Acute Illness with Systemic Symptoms it is noted that “fever, body aches and

fatigue” are not considered systemic symptoms in a minor illness.

Please confirm that the use of “minor illness” in the definition directly refers to a “self-limited or

minor problem” and does not mean that fever, body aches and fatigue are carved out as systemic

symptoms in all other types of illness (stable chronic, acute uncomplicated, undiagnosed new

problem, etc.).

Unique Test

We would appreciate clarification on how the CPT code is the driver of the determination of

“unique” and how this applies to many of the newer tests. Specifically in cases when there are

unique tests with individual CPT codes, and there is also a CPT for running those tests collectively.