Defending an Adverse E/M Audit: What the E/M Guidelines Really Say
It is essential to understand what is in the guidelines and, more importantly, what is not. With this information, you will be better able to defend decisions relative to selection of the appropriate level of E/M code or defend against inappropriate down-coding.
You Will Learn:
- Areas within the E/M guidelines that require subjective analysis, leading to disputes regarding E/M Code Levels.
- Common approaches to E/M analysis that require using tools external to the guidelines and the implications of this fact when reporting audit results.
- Identification of errors - applying the express provisions of the guidelines to effectively challenge inappropriate down-coding of E/M Services.
CEU approved for all CPCs, CPC-Hs, CPC-Ps and the following specialties: CANPC, CCC, CCVTC, CPCO, CPCD, CEDC, CEMC, CFPC, CGIC, CGSC, CHONC, CIMC, CPMA, COBGC, COSC, CENTC, CPEDC, CPRC, CRHC, CUC
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About The Presenter
Mr. Miscoe has a bachelor's of science degree from the United States Military Academy, a juris doctorate degree from Concord Law School, is a Certified Professional Coder, Certified Ambulatory Surgical Coder, Certified Urology Coder, Certified Chiropractic Professional Coder, Certified Healthcare Compliance Consultant, the President of Practice Masters, Inc., and the founding partner of Miscoe Health Law, LLC. He is a past member of the AAPC National Advisory Board and is a current member of the AAPC Legal Advisory Board. He is admitted to the Bar in the state of California as well as to the practice of law before the US District Courts in the Southern District of California and the Western District of Pennsylvania.
Mr. Miscoe has nearly twenty years of experience in health care coding and over thirteen years as a compliance expert testifying in civil and criminal cases. He has an extensive national speaking background and has been published in numerous national publications on a variety of coding, compliance, and health law topics.
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