New guidelines for coding physicians' services--a step backward.

In July 1998, the Health Care Financing Administration (HCFA) intended to implement a revised and more complex set of guidelines specifying how physicians should code and document “evaluation and management” services billed to Medicare. These services include office visits and hospital visits and are distinguished from surgery and other invasive procedures. In 1996, Medicare payments for evaluation and management services totaled about $16 billion, or 40 percent of payments to physicians under the program.1 Before the proposed date of implementation, the new guidelines created considerable turmoil among practicing physicians and were a subject of spirited and sometimes angry commentary in . . .