Official says not to fear full-blast audit if you take part in E/M pilot

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This news article covers HCFA’s explanation of how claims review would work during the draft E/M guideline pilot tests and why that clarification mattered to participating physicians and medical organizations. It is relevant to physicians, compliance staff, and coding professionals monitoring evaluation and management policy changes, claim review procedures, and concerns about audit exposure during the pilot period.

Why This Topic Matters

The article helps readers understand the broader compliance and operational implications of participating in an E/M pilot program, including how claims review policy may affect physician participation and administrative risk.

What You Will Learn

  • How HCFA described claim review during the E/M pilot tests
  • Why physician organizations were concerned about audit exposure
  • What kinds of policy details participants wanted clarified before joining the pilot
  • How the pilot was framed as part of the transition to finalized E/M guidance

Who Should Read This

  • Physicians
  • Medical practice administrators
  • Coding and compliance professionals
  • Healthcare regulatory staff
  • Physician specialty organizations

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