Medicare Compliance & Reimbursement - 2007 Issue 32
AUDITS: Find Hidden Revenue in Common Code Claims
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Article Overview
This premium article discusses how to focus audit efforts on high-impact billing areas that commonly affect practice revenue and compliance. It covers broad audit targets such as evaluation and management services, modifier use, consultation coding, and other areas that payers and oversight bodies often scrutinize. The piece is aimed at coding, billing, compliance, and practice management professionals who want to understand where routine chart review can uncover problems or opportunities.
Why This Topic Matters
Targeted audits can reveal patterns that affect reimbursement, denials, and compliance exposure. Knowing which areas receive the most attention helps practices prioritize review efforts and monitor coding behavior more effectively.
What You Will Learn
- How to prioritize internal audit efforts around high-impact billing areas
- Why certain evaluation and management services receive close payer scrutiny
- How modifier usage can influence claim review focus
- Why consultation-related services are often monitored closely
- How audit findings can affect revenue integrity and compliance oversight
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Practice managers
- Physician educators
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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