decisionhealth Newsletters, Part B News - 2001 Issue 2 (February)
Draft E/M clinical guidelines could be based on some of your claims
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Article Overview
This article covers a Medicare/HCFA effort to develop draft evaluation and management documentation guidance using selected clean claims and related contractor materials. It is relevant to physicians, coders, compliance staff, and payer-side reviewers who follow E/M documentation policy development and Medicare administrative process updates. The piece also notes the contractor involvement and the broad claim categories selected for review.
Why This Topic Matters
It signals how real-world claims data may influence future E/M documentation guidance and training materials, making it important for organizations that monitor Medicare policy development, claim review practices, and documentation education.
What You Will Learn
- How HCFA planned to use selected clean claims in developing draft E/M clinical examples
- What kinds of claim records and carrier materials were being collected
- Which Medicare contractors were involved in the process
- How the effort related to E/M documentation guideline development
Who Should Read This
- Physicians
- Medical coders
- Coding auditors
- Compliance staff
- Practice managers
- Medicare contractors
- Clinical documentation improvement staff
Code Ranges Discussed
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