Introduction Wow! I can’t believe it’s already been a year using the new 2021 E/M guidelines for outpatient office visit services. It seems like yesterday we were all scrambling to prepare our physicians, coders, and billing staff for the changes to come. As I look back throughout the year, it’s been somewhat of a roller coaster ride as I have reviewed audit results with coders and physicians across the country. Early in the year it became apparent that the saying, “old habits die hard” is true. There was one orthopedic physician that stands out in my memory. This was the first audit we performed for this physician applying the 2021 EM guidelines. His overall E/M

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