DecisionHealth, DecisionHealth - 2012 Issue 6 (June)

Appeal 1 MAC’s unprecedented E/M interpretation that exam always required

Those of you in Ohio and Kentucky received startling news from your Medicare administrative contractor (MAC) – Cigna Government Services (CGS) – last month that examination must always be documented on an established patient E/M note, regardless of the level.If CGS is your MAC and you receive an E/M denial for that reason, mount an appeal, experts say.

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