Evaluation and Management Guidelines — Fatally Flawed

Earlier this year, the Health Care Financing Administration (HCFA) and the American Medical Association (AMA), through its Current Procedural Terminology editorial panel, jointly issued draft guidelines for documenting cognitive services (evaluation and management) in the medical record. The guidelines were so stupefyingly complicated, irrelevant to actual patient care, and adversarial in intent that a grass-roots rebellion arose at the AMA's meeting in June. At the committee meeting that discussed evaluation and management guidelines, delegates from nearly every state denounced the plan heatedly, and the House of Delegates overwhelmingly passed a motion rejecting the guidelines and promising to “oppose any documentation . . .