Audit your NPPs on their E/M level selection

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

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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