decisionhealth Newsletters, Part B News - 2012 Issue 5 (May)
Audit your NPPs on their E/M level selection
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Article Overview
This article summarizes a report from the HHS Office of Inspector General examining patterns in higher-level evaluation and management coding and how those findings may affect practices that employ nurse practitioners and physician assistants. It explains why compliance programs should include internal review of E/M documentation and why audit attention may need to be tailored across physicians and nonphysician practitioners. The piece is aimed at coders, compliance staff, and practice leaders who oversee E/M coding accuracy and audit readiness.
Why This Topic Matters
Practices may face increased scrutiny when E/M level selection patterns appear concentrated at higher levels, making internal auditing and documentation oversight important for compliance planning.
What You Will Learn
- How an OIG report frames concerns about higher-level E/M coding patterns
- Why internal E/M auditing is recommended as part of a compliance plan
- Why audit oversight may need to differ across physicians and nonphysician practitioners
- How practice leaders can use coding pattern review to support documentation compliance
Who Should Read This
- Medical coders
- Compliance officers
- Practice managers
- Physicians
- Nurse practitioners
- Physician assistants
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