decisionhealth Newsletters, Part B News - 2005 Issue 5 (May)
Choose the DGs that best suit your practice
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Article Overview
This article explains how different Medicare E/M documentation guideline versions may affect documentation style, audit support, and specialty-specific reporting. It is aimed at coders, compliance staff, and providers who document E/M services and need a general overview of guideline selection, documentation considerations, and unlisted E/M reporting issues.
Why This Topic Matters
E/M documentation is a common source of audit and payment review, so understanding the broader guideline framework and documentation expectations can affect coding consistency and claim defensibility. The article helps readers gauge whether the premium content is relevant to their specialty, documentation workflow, and reimbursement review concerns.
Article Sections
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Choosing Between the 1995 and 1997 Documentation Guidelines
Compares the two Medicare documentation guideline versions and discusses how they may fit different practice types and specialties. It also addresses general audit and specificity considerations.
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Tips for both versions of guidelines
Summarizes general documentation and exam-recording topics that apply regardless of guideline version. The section focuses on broad charting habits and history documentation.
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Report 99499 when documentation does not support another E/M code
Covers unlisted E/M reporting in the context of documentation review and payment adjustment. It also discusses carrier behavior, remittance signaling, and general denial patterns.
What You Will Learn
- How the article frames the choice between two Medicare E/M documentation guideline versions
- What general documentation topics are emphasized for E/M services
- How the article addresses unlisted E/M reporting in audit and payment-review situations
- What types of payer and carrier practices are discussed in connection with E/M claims
Who Should Read This
- Medical coders
- Coding auditors
- Compliance officers
- Physicians and clinical providers
- Practice administrators
- Reimbursement consultants
Codes Discussed
Modifiers Discussed
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