Auditor's Worksheet Designed to Help, Not Hamper E/M Coding

Why This Topic Matters

Understanding the worksheet’s structure and where users commonly struggle can help coding staff review E/M documentation more consistently and avoid preventable auditing or reimbursement issues. It also highlights the importance of verifying whether local Medicare carriers recognize the worksheet.

Article Sections

1. Overview of the Marshfield Clinic Auditor's Worksheet

   Introduces the worksheet as a tool for E/M auditing and describes its role in helping users navigate documentation review. The section frames the article’s focus on common difficulties encountered by emergency department coders.

2. The Common 'Complexity' Problem: 3 Vs. 4 Points

   Discusses a recurring point-assignment issue in the worksheet’s complexity area. The section centers on distinctions within the diagnoses or treatment options grid and why that area draws attention from coders.

3. The Solution

   Presents the article’s discussion of how the worksheet’s framework is applied in a clinical scenario. It also addresses how the worksheet’s wording is interpreted in relation to physician evaluation and follow-up planning.

4. Another Consideration: Defining 'Additional WorkUp'

   Explores broader considerations for deciding whether planned follow-up falls within the worksheet’s framework. The section also notes the importance of understanding local practice context and carrier expectations.