Compliance: How Will Recent Media Hype On EHRs And Upcoding Impact Your Compliance Plans?

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains why emergency department evaluation and management coding patterns drew attention in 2012 and how hospitals and physician groups were responding to questions about documentation and compliance. It focuses on broad coding and compliance themes such as acuity trend analysis, comparisons with peer data, documentation quality review, EHR-related concerns, and fraud-and-abuse risk. The discussion is aimed at emergency medicine compliance staff, coders, physicians, and revenue cycle professionals who need context for audit readiness and internal review planning.

Why This Topic Matters

The article helps readers understand why ED coding trends can attract audit scrutiny and what kinds of compliance reviews organizations may want to consider when evaluating documentation and coding patterns.

Article Sections

  1. Background on ED coding scrutiny and public reporting

    Introduces the public attention surrounding emergency department coding trends and summarizes the broad concerns raised by government and media reports.

  2. Factors discussed as possible drivers of acuity changes

    Reviews several broad reasons presented for changes in ED coding patterns, including shifts in patient mix, changes in care settings, and documentation evolution.

  3. Compliance review and audit preparedness

    Outlines general compliance strategies such as benchmarking, internal case review, and examination of EHR documentation practices.

What You Will Learn

  • How public reports can affect attention to emergency department coding patterns
  • What broad factors may influence observed changes in acuity distribution
  • What kinds of internal compliance reviews are discussed for audit readiness
  • Why EHR documentation practices are part of the compliance conversation

Who Should Read This

  • Emergency department physicians
  • Hospital compliance staff
  • Medical coders and auditors
  • Revenue cycle professionals
  • Coding quality assurance teams

Codes Discussed


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