RAC Audits: Shore Up Your SNF Coding Before Auditors Come Knocking

Why This Topic Matters

Skilled nursing facility E/M claims can attract audit scrutiny, so understanding the scope of the article can help organizations assess whether their workflows, documentation practices, and code selection processes are aligned with Medicare expectations.

Article Sections

1. RAC points you toward problem areas you can fix now

   Introduces the audit focus on SNF evaluation and management services and frames the coding and documentation issues addressed in the article.

2. Know How to Tally E/M

   Discusses how to approach coding for nursing facility encounters when the visit purpose and documentation do not match the most obvious code choice.

3. Nail Down Timing

   Reviews general time-based reporting considerations for nursing facility E/M services and the documentation themes associated with that approach.

4. Rules Should Stay the Same for Specialists

   Covers specialist participation in nursing facility visits, related Medicare guidance, and a modifier discussed in connection with physician roles.