Medicare Compliance & Reimbursement - 2010 Issue 32
E/M Coding: 3 Tips Are Key to Deciphering 99213 From 99214
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Article Overview
This article explains general evaluation and management coding issues for established patient office and outpatient services, with emphasis on comparing documentation levels, understanding payer-specific expectations, and recognizing billing patterns that may draw scrutiny. It is intended for coders, billers, auditors, and practice staff who want to assess whether their E/M coding habits align with documentation and common payer review practices.
Why This Topic Matters
Accurate E/M level selection affects reimbursement, compliance, and audit risk. The article highlights why practices should rely on documentation and internal review processes rather than habitual coding patterns.
What You Will Learn
- How documentation review supports E/M level selection
- Why payer-specific definitions matter in evaluating visit levels
- How recurring billing patterns can affect audit attention
- The role of auditing tools in E/M coding review
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance auditors
- Physician office staff
Codes Discussed
Code Ranges Discussed
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