Between a rock and a hard place with E/M coding: dilemmas of compliance and practice financial viability

Compliance with HCFA's Evaluation and Management (E/M) documentation guidelines presents a tremendous challenge to physicians and their staffs due to the complexity of the guidelines. All too frequently, physicians and staff undercode the services actually provided to prevent additional scrutin...

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Published inThe Journal of medical practice management Vol. 16; no. 1; p. 22
Main Authors Sosa, R E, Cascardo, D
Format Journal Article
LanguageEnglish
Published United States 01.07.2000
Subjects
Centers for Medicare and Medicaid Services (U.S.)
Documentation
Forms and Records Control
Humans
Insurance Claim Reporting - standards
Insurance, Health, Reimbursement
Practice Management, Medical - economics
Practice Management, Medical - organization & administration
Risk Management
United States
United States
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Abstract Compliance with HCFA's Evaluation and Management (E/M) documentation guidelines presents a tremendous challenge to physicians and their staffs due to the complexity of the guidelines. All too frequently, physicians and staff undercode the services actually provided to prevent additional scrutiny and fraud and abuse charges. This results in significant lost revenue for the practice. This article provides guidance on how to ensure accurate reimbursement while complying with E/M guidelines. Special direction is provided on when and how to bill for a consultation.
AbstractList Compliance with HCFA's Evaluation and Management (E/M) documentation guidelines presents a tremendous challenge to physicians and their staffs due to the complexity of the guidelines. All too frequently, physicians and staff undercode the services actually provided to prevent additional scrutiny and fraud and abuse charges. This results in significant lost revenue for the practice. This article provides guidance on how to ensure accurate reimbursement while complying with E/M guidelines. Special direction is provided on when and how to bill for a consultation.
Author Cascardo, D
Sosa, R E
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Snippet Compliance with HCFA's Evaluation and Management (E/M) documentation guidelines presents a tremendous challenge to physicians and their staffs due to the...
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SubjectTerms Centers for Medicare and Medicaid Services (U.S.)
Documentation
Forms and Records Control
Humans
Insurance Claim Reporting - standards
Insurance, Health, Reimbursement
Practice Management, Medical - economics
Practice Management, Medical - organization & administration
Risk Management
United States
Title Between a rock and a hard place with E/M coding: dilemmas of compliance and practice financial viability
URI https://www.ncbi.nlm.nih.gov/pubmed/14608765
Volume 16
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