Compliance: ED Coders: Expect Close Scrutiny on E/M Claims
EHRs being made the culprit of E/M code abuse.
The sharp rise in upcoding of evaluation and management encounters in emergency departments is being attributed to the increase in EHR use by the media and the HHS Office of the Inspector General. In May 2012, the HHS OIG issued a report citing that ED E/M’s were the fifth largest paying codes in Medicare among all of the E/M codes, says Ed Gaines, JD, CCP Chief Compliance Officer for Medical Management Professionals, Inc, in Greensboro, NC.
While acknowledging that it had not performed chart or medical record reviews of...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: