New Chronic Condition Rule for 2021

New Chronic Condition Rule When Tallying Number of Problems

To count a problem under medical decision making element 1, “Number and
complexity of the problem/problems that the provider addresses during the
patient visit,” the current provider must address it at the current visit — you may not count a problem managed by different provider, unless the current provider gives a separate assessment or care for that problem.

The 2021 E/M guidelines use the same terms as the current (1995/1997) guidelines — like acute, chronic, stable, systemic, and more. What’s new is that the guidelines now provide definitions for many of the terms. For example, you now have a definitive rule for defining a stable or chronic condition; it’s one that is indicated as lasting “at least a year or until the death of the patient.”