Learn from practices on OIG’s E/M watch list; document patient severity for level 4s, 5s

Why This Topic Matters

Higher-level E/M billing can attract audit attention, so practices need strong documentation, consistent internal processes, and compliance programs to support billing patterns and reduce denials or recoupment risk.

Article Sections

1. E/M billing

   Introduces the article’s focus on higher-level office visit billing and why certain practices drew attention. Summarizes the overall compliance and documentation theme.

2. Three characteristics seen at the high-level billing practices

   Describes broad practice traits reported by offices that frequently bill higher-level E/M services. Covers patient complexity, audit experience, and how some organizations respond internally to billing scrutiny.

3. Justify your level 4s and 5s

   Outlines general approaches for reviewing E/M billing patterns and strengthening internal oversight. Emphasizes benchmarking, analytics, training, and compliance planning.