Benchmarking: How Will Your 99285 Claims Stack Up in an Audit?

Why This Topic Matters

Peer-benchmark reports can flag outlier billing patterns and prompt audits or internal reviews. Understanding the broad themes in the report helps practices evaluate documentation and compliance processes for emergency department E/M services.

Article Sections

1. Background and purpose of the comparative billing report

   Introduces the Medicare comparative billing report and explains the general reason the analysis was produced. It also places the report in the context of billing trend monitoring across emergency medicine services.

2. Take a look at the findings

   Summarizes the broad categories of findings discussed in the report, including variation patterns and benchmarking observations. It frames the report’s focus on service-level and utilization comparisons.

3. Documentation considerations for emergency department reporting

   Reviews general documentation themes tied to emergency department E/M reporting, including the role of the history, exam, and medical decision-making components. It also notes a special documentation circumstance discussed in the article.