decisionhealth Newsletters, Part B News - 2012 Issue 4 (April)
WPS: Status of 3 chronic conditions accepted with 97 guidelines only
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Article Overview
This article explains a WPS Medicare documentation update affecting evaluation and management (E/M) history of present illness requirements. It is aimed at physicians, coders, compliance staff, and practice managers who need to understand how documentation expectations differ under the referenced E/M guideline sets and why existing templates may need review. The article also places the change in the context of contractor guidance, MAC policy, and practice workflow impact.
Why This Topic Matters
The update may affect how practices document patient histories and maintain compliant E/M records, which can influence claim support, audit risk, and internal documentation workflows.
Article Sections
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E/M documentation
Overview of the documentation topic and the general comparison between the referenced E/M guideline sets. The section frames the practical impact on history documentation and office workflows.
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WPS no longer using CMS communication
Explains the contractor policy context behind the change and why existing guidance is being revised. It also notes the need to update templates and electronic health record materials.
What You Will Learn
- How the article frames a WPS update to E/M documentation expectations
- Why practices may need to review history documentation templates and training
- What broader operational impact the policy change may have on documentation workflows
- How contractor guidance and administrative policy can affect compliance practices
Who Should Read This
- Physicians
- Medical coders
- Compliance auditors
- Practice managers
- Revenue cycle staff
- Health information management professionals
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