There has been no meaningful reduction in EHR documentation burden in association with implementation of new guidelines for outpatient evaluation and management (E/M) billing, according to a study published in the Annals of Internal Medicine. Nate C. Apathy, PhD, and colleagues analyzed outpatient E/M visits, documentation length, and time spent in the EHR before and after the 2021 AMA guidance change for frequently used billing codes. Weekly provider-level E/M code and EHR use metadata were extracted from September 2020 through April 2021 for US-based ambulatory practices using the Epic Systems EHR. Following implementation of the new guidelines, there was a 2.41 percentage point decrease in level 3 visits to 38.5% of all E/M visits (5.9% relative decrease from fall 2020). There was a 0.89 percentage point increase in level 4 visits to 40.9% of E/M visits and a 1.85 percentage point increase in level 5 visits to 10.1 percent of E/M visits (relative increases of 2.2% and 22.6%, respectively). Variation in these changes was noted by specialty. No meaningful changes were seen in measures of note length or time spent in the EHR.
