decisionhealth Newsletters, Part B News - 2013 Issue 5 (May)
Benchmark of the Week: Upper level E/M visits see huge utilization gains over 5 years, 2007-2011
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Article Overview
This article summarizes a Part B News analysis of CMS claims data showing changes in evaluation and management visit utilization from 2007 to 2011. It is relevant to physicians, coders, auditors, compliance staff, and practice administrators who monitor E/M billing patterns, documentation trends, and Medicare oversight activity. The discussion focuses on broad utilization shifts, electronic health record documentation effects, and the audit environment surrounding higher-level E/M services.
Why This Topic Matters
Understanding shifts in E/M utilization helps readers gauge coding patterns, documentation influences, and why higher-level office visit claims may attract payer or government scrutiny.
What You Will Learn
- How E/M utilization changed over a five-year period in CMS claims data
- What broad documentation and EHR-related factors were discussed as possible contributors
- Why higher-level E/M billing patterns may attract audit attention
- How the article frames the relationship between utilization trends and Medicare oversight
Who Should Read This
- Medical coders
- Physicians
- Compliance professionals
- Auditors
- Practice administrators
Codes Discussed
Code Ranges Discussed
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