2023 MDM and E/M Code Updates

Swiftaudit now supports all current AMA updates to Medical Decision Making and E/M code calculations. We’ll be posting a series of educational discussion pieces over the next few weeks to dig deeper into these changes, so stay tuned! In the meantime, here is a brief summary of revisions.

2023 summary of revisions to the E/M code descriptors and guidelines

Inpatient and observation care services

  • Deletion of observation CPT codes (99217-99220, 99224-99226) and merged into the existing hospital care CPT codes (99221, 9922299223, 99221-99233, 99238-99239).
  • Editorial revisions to the code descriptors to reflect the structure of total time on the date of the encounter or level of medical decision-making when selecting code level.
  • Retention of revised Observation or Inpatient Care Services (Including Admission and Discharge Services) (99234-99236).
  • Revision of guidelines.


  • Retention of the consultation codes, with minor, editorial revision to the code descriptors.
  • Deletion of confusing guidelines, including the definition of “transfer of care.”
  • Deletion of lowest level office (99241) and inpatient (99251) consultation codes to align with four levels of MDM.

Emergency department services

  • Maintained the existing principle that time cannot be used as a key criterion for code level selection.
  • Editorial revisions to the code descriptors to reflect the code structure approved in the office visit revisions.
  • Modified MDM levels to align with office visits and maintain unique MDM levels for each visit.
  • Existing CPT code numbers maintained (analogous to office visit revisions).
  • Articulated current practice that was not explicit in the CPT code set.
    • May be used by physicians and QHPs other than just the ED staff.
  • Critical care may be reported in addition to ED service for clinical change.

Nursing facility services

  • Editorial revisions to the code descriptors to reflect the new standard E/M code structure.
  • Revision to nursing facility guidelines with new “problem addressed” definition of “multiple morbidities requiring intensive management,” to be considered at the high level for initial nursing facility care.
  • Deletion of code 99318 (annual nursing facility assessment). This existing service will be reported through the subsequent nursing facility care services (99307-99310) or Medicare G codes.
  • Not all “initial care” codes are the mandated comprehensive “admission assessment” and may be used by consultants.
  • Use subsequent visit when the principal physician’s team member performs care before the required comprehensive assessment.

Home and residence services

  • Editorial revisions to the code descriptors to reflect the new standard E/M code structure.
  • The domiciliary or rest home CPT codes (99334-99340) were deleted and merged with the existing home visit CPT codes (99341-99350).
  • Elimination of duplicate MDM Level New Patient code (99343).

Prolonged services

  • Deletion of direct patient contact prolonged service codes (99354-99357). These services will now be reported through either the code created in 2021, office prolonged service code (99417) or the new inpatient or observation or nursing facility service code (993X0).
    • 99417 is also used for Home or Residence prolonged services.
  • Creation of a new code (993X0) to be analogous to the office visit prolonged services code (99417). This new code is to be used with the inpatient or observation or nursing facility services.
  • Retention of 99358, 99359 for use on dates other than the date of any reported ‘total time on the date of the encounter” service.

More Information:

Review and download the E/M code descriptors and guidelines for 2023.


Swiftaudit New Products Release

We’re excited to announce the upcoming launch of our new products and features for Swiftaudit.

For the past year, the SpringSoft Medical team has worked to add several new features to our core Swiftaudit Essentials platform. We listened to you, designing features to make your jobs easier.

On March 1, 2022 our new Swiftaudit product series will be online and available:
CodeBook which provides access to our Coding Tools on your phone, tablet or PC.
Essentials is our core Swiftaudit platform supporting pro-fee reviews, and includes Codebook.
Standard starts with Essentials and adds the ability to upload billing data into an auditor work queue.
Standard+RA supports reviews for pro-fee and risk adjustment.

In addition to these new products and features, we are upgrading our payment platform with improved invoices and payment receipts.

To facilitate the launch of our new product line, there will be a brief interruption of service from 8:00AM to 9:00AM on Tuesday, March 1st, 2022 (EST).

Swiftaudit will be unavailable during this time.

Meet our Experts

Barbara J. Cobuzzi


Barbara is a dynamic speaker and educator. Barbara speaks at many local and national organizations.

Barbara founded CRN Healthcare Solutions which offers provider consulting services. As an expert witness, Barbara provides litigation support for providers and payers.

She is also the Consulting Editor of Otolaryngology Coding Alert. In the past, Barbara was a member of the AAPC National Advisory Board and their Executive Board.

Leslie Johnson, CPC

Leslie will help you understand the impact of coding compliance to you and your providers.

Leslie is one of the founders of Jobs for American Medical Coders (JFAMC).
For over 15 years, Leslie has been a speaker at national and local conferences for groups such as local AAPC chapters, Decision Health’s Advance Specialty Coding Symposium and The Coding Institute’s CodingCon national coding conferences. Her coding articles have been published in Becker’s Online Review, BC Magazine and Find-a-Code.

She is a subject matter expert in Anesthesia and Pain Management, Orthopedics and general medical billing and coding topics.

Jill Young


Jill is a knowledgeble speaker and educator, who breaks down the “fine print” of coding compliance.

Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her background gives her a unique style of teaching using real life examples of coding and billing situations.

Her comments and opinions can be seen in several publications and heard on a variety of audio-conferences.

COVID-19 Fact Sheets

Check out this great collection of easy-to-read and informative COVID-19 fact sheets. Created by the COVID-19 Health Literacy Project in collaboration with Harvard Health Publishing, these fact sheets cover everything from basic information on how to prevent and manage the virus, to colorful tips and explanations designed specifically for children and young adults. Click on the link below to access the full set!

COVID-19 Health Literacy Project

New CPT Code for COVID-19 Testing

As health professionals and auditors, we’re all very much involved in recording data for the testing and treatment of the novel coronavirus (COVID-19). As of this week the AMA has announced the addition of a new CPT code to help record and track patients who are impacted by the virus.

The new Catergory I CPT code and descriptor are:

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique

This new code is effective immediately for use as the industry standard for the reporting of tests for the novel coronavirus across the nation’s health care system and has been fully integrated into our Swiftaudit software.

For more information on how to properly code COVID-19:

Tips and Coding Guidance-COVID-19

ICD-10-CM Official Coding Guidelines – Supplement