Coding Errors: CMS Unveils Error Rates: Chiropractic And E/M Services Top The List

Why This Topic Matters

Understanding CMS error-rate reporting helps practices recognize where claims may attract review and where documentation quality matters most. The article is relevant to organizations that bill E/M services or work in specialties identified in the CERT tables.

Article Sections

1. Background

   Introduces the CMS CERT results for 2010 and explains that the appended tables provide more detail on service categories and specialty trends.

2. E/M Services Rack Up High Errors

   Summarizes the report’s findings for evaluation and management service categories and other high-error service types.

3. What this means:

   Provides broad guidance about claim accuracy and documentation for services discussed in the error-rate tables.

4. Neurosurgeons, CRNAs See Low Error Rates

   Describes specialties that showed lower error rates in the CERT report and contrasts them with higher-error groups.

5. What this means:

   Offers general observations about payer review and the importance of complete documentation for affected specialties.

6. CMS Eyeing E/M Codes

   Reviews longer-term CMS attention to evaluation and management coding and summarizes trends reported for one outpatient E/M code over time.

7. What this means:

   Discusses the need for documentation-supported E/M reporting and the risk of both overcoding and undercoding.