In Audit
Sep 14th, 2018
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has provided its latest, monthly Work Plan update. The Work Plan “sets forth various projects including OIG audits and evaluations that are underway or planned to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and ...
In CMS
Sep 4th, 2018
Comments Off on Medicare Proposes Big E/M Changes
Be aware of three proposals that would make coding these services easier, but also may negatively affect physician reimbursement. The Centers for Medicare & Medicaid Services (CMS) has proposed radical changes that, if finalized, would ease the documentation requirements for new and established outpatient visits, while also creating a uniform payment for evaluation and management ...
Most E/M auditors work diligently to hone their craft. They are experts on the CMS 1995 and 1997 Documentation Guidelines, they can spot a troublesome template a mile away, and they work hard to ensure that physicians comply with stringent regulations and rules. They are generally careful, decisive, and thorough communicators. The effort generally pays ...
By Brenda Edwards, CPC, CPB, CPMA, CPC-I, CEMC A new category of evaluation and management (E/M) services was introduced in January. Chronic Care Management (CCM) services are provided to a patient who has two or more chronic conditions expected to last at least 12 months, or until the death of the patient. The conditions place ...
In Coding
Feb 1st, 2010
When time captures reimbursement, every minute counts. By G. John Verhovshek, MA, CPC As CPT® evaluation and management (E/M) service guidelines explain, “When counseling and/or coordination of care dominates … the physician/patient and/or family encounter … time may be considered the key or controlling factor to qualify for a particular level of E/M services.” Specifically, ...