tci Medicare Compliance & Reimbursement - 2017 Issue 20
Compliance: NGS Steps Back Its E/M Exam Policy Change Decision
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Article Overview
This compliance-focused article explains a Medicare Administrative Contractor update affecting evaluation and management documentation review. It is intended for physicians, coders, auditors, and billing staff who need to track payer policy changes and understand how they relate to the existing documentation guideline framework used for E/M services. The article discusses the contractor’s revised position, the comparison between documentation guideline approaches, and a reminder about the contractor’s training tool.
Why This Topic Matters
Payer policy changes can affect how E/M documentation is reviewed on audit and how practices interpret medical record support. Staying current helps coding and compliance teams align documentation habits with applicable guidance and avoid confusion about what is required versus what is suggested.
What You Will Learn
- How a Medicare contractor revised its position on E/M exam documentation expectations
- How the article frames the relationship between older documentation guideline options and the contractor’s updated guidance
- What documentation resources the contractor says remain unchanged
- How compliance teams may think about audit support and payer expectations at a high level
Who Should Read This
- Physicians
- Medical coders
- Coding auditors
- Compliance staff
- Practice managers
- Billing staff
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