tci Medicare Compliance & Reimbursement - 2004 Issue 23

PHYSICIANS: No E/M Coding Changes Until 2006

Clinical examples are too subjective to please CMS auditors. Physicians shouldn't throw away their calculators yet. They'll be using the points system for evaluation and management coding for another year. A recent meeting of the E/M editorial panel reviewed the results of the pilot group that tried to code using clinical examples instead of the 1995 or 1997 guidelines. The panel went over the E/M coding that physicians arrived at from the case scenarios posted online by the American Medical Association. The results were not encouraging, say sources close to the process. Originally, "clinical examples" were supposed to take...

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