Wiki Audit topics for EM Services

[sahni.vani@gmail.com]

Hi All--I am looking for various topics to audit EM services for my audit project. If you have any ideas , please write them down . Thanks Vani

 

[TTcpc]

Hi All--I am looking for various topics to audit EM services for my audit project. If you have any ideas , please write them down . Thanks Vani

Hello, Can you please clarify? Most I would think audit E/M services to ensure the level is appropriate for the documentation and also audit the diagnosis. Not sure what you mean by "various topics to audit"

 

[jkyles]

Hi there, I recommend checking available information such as targeted probe and educate reports issued by the MACs, comparative billing reports and the annual CERT report to see what auditors and other reviewers are already looking at. In addition:

1. E/M visits provided via telehealth.
2. For office/other outpatient codes in 2021, did providers and coders follow the new guidelines? You might want to break that into MDM-based coding and time-based coding.

 

[sahni.vani@gmail.com]

Hello, Can you please clarify? Most I would think audit E/M services to ensure the level is appropriate for the documentation and also audit the diagnosis. Not sure what you mean by "various topics to audit"

I apologize for any confusion. I'm looking for the same information JKyles mentioned .

 

[sahni.vani@gmail.com]

Hi there, I recommend checking available information such as targeted probe and educate reports issued by the MACs, comparative billing reports and the annual CERT report to see what auditors and other reviewers are already looking at. In addition:

1. E/M visits provided via telehealth.
2. For office/other outpatient codes in 2021, did providers and coders follow the new guidelines? You might want to break that into MDM-based coding and time-based coding.

Thank you very much . I will investigate the mentioned reports for current billing trends .