decisionhealth Newsletters, Part B News - 2011 Issue 10 (October)
Benchmark of the Week: E/M code selection by specialty, 2009 vs. 2010
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Article Overview
This benchmark article looks at shifts in E/M coding patterns over time, comparing primary care with high-volume specialist groups and focusing on how utilization changed between 2009 and 2010. It is useful for coders, compliance staff, and practice leaders who track E/M distribution trends, specialty-level coding behavior, and the impact of Medicare policy changes on outpatient visit coding. The article discusses broad utilization patterns, specialty comparisons, and the influence of CMS changes and EHR adoption on coding trends.
Why This Topic Matters
It helps readers understand how specialty mix and policy changes can affect E/M coding patterns, which is important for benchmarking, auditing, and monitoring documentation-driven shifts in visit leveling.
Article Sections
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Summary
Overview of the article’s E/M coding trend comparison between primary care and specialist groups across two years.
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Breakdown
Expanded discussion of the utilization shift across visit levels, specialty differences, and the broader context of Medicare-related coding changes.
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Takeaways
High-level observations about specialty-level impact and the broader trend toward documentation-driven E/M coding changes.
What You Will Learn
- How E/M utilization patterns changed over time across different specialty groups
- How benchmark comparisons can highlight shifts in visit-level selection
- How Medicare policy changes can affect specialty coding patterns
- How documentation and EHR adoption may influence coding trends
Who Should Read This
- Medical coders
- Coding auditors
- Compliance professionals
- Revenue cycle staff
- Physician practice managers
Codes Discussed
Code Ranges Discussed
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