Compliance: Auditors Question E/M Visits With Pulmonary Services

Why This Topic Matters

The article helps readers recognize areas of Medicare audit attention so they can assess whether their billing patterns may warrant closer internal review. It is especially relevant for practices that submit E/M services alongside pulmonary diagnostic services or that report hydration therapy.

Article Sections

1. Double-Check Your E/M Claims

   This section discusses Medicare audit attention on evaluation and management claims submitted in connection with pulmonary diagnostic services. It summarizes the general compliance concerns raised in the newsletter and the type of claim pattern being reviewed.

2. RACs Hunting for Hydration Therapy Diagnoses

   This section covers audit scrutiny of hydration therapy claims and the importance of diagnosis specificity in supporting those claims. It describes the broader compliance issue highlighted by CMS and RAC reviewers.