Beat the OIG to the Punch: Benchmark Against CMS

Why This Topic Matters

Benchmarking can help a practice identify possible coding variances before they draw compliance attention and can also reveal missed legitimate reimbursement opportunities. The article is relevant for organizations that review evaluation and management utilization, monitor physician-level trends, or use CMS data as part of internal auditing and compliance efforts.

Article Sections

1. Boost your practice's coding accuracy with concrete data from national stats

   Introduces the general idea of using national utilization data to compare coding patterns and identify areas that may merit review.

2. Why E/M Benchmarking Works

   Explains the rationale for evaluation and management benchmarking, including why population mix can affect comparison results and why broad utilization analysis is commonly used.

3. Don't Take CMS Averages as Gospel

   Reviews cautions about relying too heavily on national averages and notes the need to consider practice setting and data limitations when interpreting comparisons.

4. Compare Your Practice to Itself

   Covers internal benchmarking over different time periods and among individual physicians as a way to assess overall coding trends and consistency.