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Tag Archives: E/M
RAC Audits are Coming to Physician Practices!
CMS communicated to the AMA on Wednesday, September 12, 2012, that it has approved the Medicare Region C Recovery Auditor(RAC) Connolly to begin conducting audits of coding for E&M services in physician offices, specifically CPT code 99215.
Posted in CMS, Coding, Documentation, E/M, Medicare, Miscellaneous, OIG, Practice Management, Regulatory
Tagged audit, E/M, HHS, OIG, RAC, Tavenner
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Co-Pays: The Dilemma of Collecting and Patient Satisfaction
The other day I received a comment from a client practice that decided not to collect on a service since, if documented correctly, would have incurred the patient another co-payment for the service, in addition to the E&M well care … Continue reading
Posted in Healthcare, Practice Management, Revenue Cycle Management, Uncategorized
Tagged Co-Pay, E/M, preventive services, Wellness vists
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High Level E/M Codes are Coming Under Increased Scrutiny by the OIG
The May 8, 2012, Office of Inspector General’s report, Coding Trends of Medicare Evaluation and Management Services, says payments for E/M services increased 5% more than the rate of increase for all Part B payments from 2001 to 2010 (48% … Continue reading
Posted in CMS, Coding, documentation, Documentation, E/M, Medicare, OIG
Tagged audits, CMS, E/M, OIG
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CMS Releases E/M Comparative Billing Report
On June 4, CMS will release a national provider Comparative Billing Report (CBR) addressing Evaluation and Management Services.
WPS: Status of 3 chronic conditions accepted with 97 guidelines only
E/M documentation Here is a follow-up article, to a prior blog post, that was reported by Karen Long of Part B News Practices that followed WPS carrier instructions to document extended history of present illness (HPI) with three or more … Continue reading
Posted in Coding, CPT, documentation, E/M, MAC, Medicare
Tagged 97 Guidelines, Chronic Conditions, E/M, HPI, Part B News, WPS
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Documentation Guidelines Interpreted Differently Based on your MAC
There are two sets of E/M documentation guidelines. In 1995, CMS released the first set of guidelines that were tailored more towards primary care. The specialists soon spoke up, stating that under the 1995 guidelines, system-focused examinations were under-represented. Responding to … Continue reading
Posted in CERT, Coding, Documentation, Medicare
Tagged CERT, CMS, Documentation, E/M, guidelines, HPI, MAC, WPS
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Justifying Your Evaluation & Management Service Level
Many providers see patients who have complex cases with multiple diagnoses. This can present a challenge when trying to select an appropriate E/M level. However, once you take the coexisting conditions and the amount of time spent counseling the patient … Continue reading
