tci Medicare Compliance & Reimbursement - 2006 Issue 36
HOSPITALS: Prepare For Imminent Audits Of ED Visits
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Article Overview
This article discusses why emergency department evaluation and management activity may attract closer audit attention and summarizes general compliance themes for hospitals and coding teams. It focuses on broad ED coding considerations, including how auditors may review documentation patterns and how organizations can prepare for scrutiny of emergency department visit levels.
Why This Topic Matters
Hospitals, emergency physicians, and coding staff need to understand the areas that may draw audit attention so they can review documentation practices and coding processes before external review occurs.
What You Will Learn
- Why emergency department evaluation and management services may face increased audit scrutiny
- What kinds of documentation patterns can raise compliance concerns
- How hospitals and coders can think about preparing for review of ED visit levels
- Why emergency department coding practices differ from coding in other settings
Who Should Read This
- Hospital compliance teams
- Emergency department coders
- Emergency physicians
- Revenue cycle and audit staff
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