E/M Coding: Incorrect Codes, Poor Notes, and Setting Debacles Add to E/M Fails
CMS sees uptick in E/M claims problems.
Evaluation and management (E/M) services are the bread and butter of most Medicare providers' paychecks. For this reason, routine errors related to mismatched codes and inadequate documentation put E/M at the top of most Medicare auditors' checklists.
According to the April 2018 Medicare Quarterly Provider Compliance Newsletter, CMS's CERT contractors are reporting that they have seen an increase in E/M claims issues due to improper coding, insufficient notes, and setting confusion. In fact, "the 2017 improper payment rate for E/M services was 12.1 percent, accounting for 10.6 percent of the...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: