E/M Coding Alert - 2016 Issue 5
Error Rates for Hospital E/M Codes Were Even Worse
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Article Overview
This article covers audit outcomes and error rates reported by NGS Medicare for hospital evaluation and management services, along with a brief mention of additional pre-payment audit results for other service categories. It is useful for coding, billing, compliance, and revenue cycle professionals who want a high-level view of documentation-related vulnerabilities and the types of services included in the review.
Why This Topic Matters
Audit results can highlight areas where documentation and claim submission processes are leading to denials or elevated error rates. Readers can use the article to gauge which service categories were reviewed and to understand the compliance focus of the payer audit activity.
Article Sections
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Hospital E/M audit results
Summarizes reported error rates for hospital evaluation and management services and describes the general documentation issues associated with denied claims.
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Additional pre-payment audit results
Briefly notes other service categories included in NGS Medicare’s pre-payment audit reporting, including therapy and diagnostic service areas.
What You Will Learn
- Which broad service categories were included in the audit discussion
- What kinds of documentation and claim submission issues were associated with denials
- How the article frames the significance of the reported error rates
- Which payer organization issued the review results
Who Should Read This
- Medical coders
- Coding auditors
- Billing specialists
- Compliance staff
- Revenue cycle professionals
- Practice managers
Codes Discussed
Code Ranges Discussed
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