decisionhealth Newsletters, Answer Books - 2010 Issue 3 (March)
Evaluation and Management Coding Tips / Auditing EM
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Article Overview
This article discusses how practices can plan and carry out evaluation and management audit activities, including scope, staffing, documentation review, reporting, and follow-up education. It also touches on common compliance-related audit considerations for E/M claims and references Medicare documentation guideline frameworks. The content is aimed at coders, auditors, compliance staff, and practice administrators who want to assess E/M billing and documentation processes.
Why This Topic Matters
E/M auditing is a core compliance activity for identifying documentation, billing, and monitoring issues in a medical practice. The article helps readers understand the broad elements involved in building an audit process and recognizing the kinds of E/M-related items that may warrant review.
What You Will Learn
- How to plan the scope and workflow of an E/M audit
- What types of records and tools are commonly gathered for review
- How audit findings can support provider education and compliance monitoring
- What broader areas may be added to an E/M audit program
- How Medicare documentation guideline frameworks are referenced in audit planning
Who Should Read This
- Medical coders
- Compliance officers
- Practice managers
- Billing staff
- Healthcare auditors
- Physician office administrators
Codes Discussed
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