My providers are currently undergoing an internal audit and I seem to have a difference of opinion on the way things are being evaluated. The scenerio is quite simple. Each provider is assigned a particular day that all there claims are going immediately on hold pending compliance review. Upon completion of the review, the auditor sends back the analysis. My difference of opinion is coming because they are only looking at the one note from that particular day and are not taking any other information into consideration when determining the level of service. In my opinion, it is important to know when the patient was last seen and the level of service that was billed. By only focusing on the one visit, I believe they are ending up coding a higer level in some instances. In my experience the audits we usually undergo from the insurance companies focus on the whole chart (or the last year anyways) and if we are billing a level 4 everytime the patient comes in because the patient has 3 chronic, but stable conditions, that screams red flag to me. I know there are many more pieces to the puzzle but I am pretty sure that medical decision making is what should drive an E/M selection and I simply feel the way they are evaluating visits is going to lead to overcoding. Any feedback would be greatly appreciated.