Carrier medical directors unhappy with E/M clinical examples

Why This Topic Matters

Changes to evaluation and management documentation guidance can affect physician documentation practices, audit expectations, and coding workflows across specialties. Understanding the concerns raised by Medicare contractors and specialty groups helps readers gauge implementation issues and policy uncertainty before broader adoption.

Article Sections

1. Carrier medical directors say examples are flawed

   This section summarizes the concerns raised by Noridian medical directors after reviewing selected specialty examples. It addresses broad objections about the examples’ completeness, comparability, and clarity.

2. Questions about how the examples will be used

   This section covers uncertainty about the role of the examples in auditing and implementation. It also notes questions about the contractor involved in developing them and the related CMS work product.

3. Additional criticism from a former CMS staffer and specialty groups

   This section outlines further skepticism from a regulatory observer and references continued concern from specialty organizations. It also touches on CMS leadership discussions with stakeholder groups.