Benchmark of the Week: Established patient E/M utilization, 2009-2011

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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 reviews Medicare utilization patterns for established patient office evaluation and management services over a three-year period. It summarizes how usage shifted across the code family, notes year-over-year changes, and places those trends in the context of federal oversight and audit attention. The piece is relevant to coders, compliance staff, auditors, and practices tracking E/M utilization trends.

Why This Topic Matters

Established patient E/M utilization trends are closely watched by payers and oversight organizations, so understanding how the distribution changed over time can help readers interpret audit focus and documentation review priorities.

What You Will Learn

  • How Medicare utilization for established patient office E/M services changed from 2009 through 2011
  • What broad trend the data suggest about lower-level versus upper-level E/M service usage
  • Which government and contractor organizations are monitoring E/M utilization trends
  • How the article frames the data in relation to audit activity and compliance attention

Who Should Read This

  • Medical coders
  • Coding auditors
  • Compliance professionals
  • Physician practice managers
  • Billing staff
  • Healthcare consultants

Codes Discussed

Code Ranges Discussed


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