Good E/M audit books

cdcpc

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After reading up on AAPC forum threads, I read someone saying that 30% of the coding books out there are wrong. That scared me.
I've been reading Joe Rivet's book entitled "Auditing Evaluation and Management Coding" and I'm wondering if anyone can vouch for this author. I want to make sure this book is not one of the bad ones!
Can anyone reccommend good resources for auditors?
What are the best credentials to have as a certified auditor?
Any advice would be appreciated!:)
 

janice.moore

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I usually prefer Barb Pierce. The problem might not be that they are necessarily wrong but that the Medicare intermediary might have different regulations. For example, TrailBlazers requires the ROS to be listed out by system whereas WPS does not. A generalized statement is still appropriate as long as one or two ROS are listed. Do you have the study guide for the E/M specialty credentialing? This might be a start.
 

cdcpc

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jls: Thank you for the reply! I honestly think this author knows what he's doing (he's a fellow CPC) but I get worried about sources sometimes. No I do not have the AAPC E/M study guide, but it's on my list of books to get!
 

valleycoder

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jls- where do you see that trailblazers requires you to write out the ROS? i have seen that mentioned twice now but cant find it in writing on the trailblazer website.

thanks!
 
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Trailblazer prohibits "all other systems negative"

Will the documented phrase or templated chart check off box "all other systems reviewed and negative" suffice in meeting the ROS requirements for a complete review of systems?
A. CMS 1995 and 1997 Documentation Guidelines both state that after pertinent positives and negatives have been addressed, then the statement "all other systems reviewed and negative" meets CMS documentation requirements for a complete ROS. When documented in this manner, some auditors assume that the physician has reviewed all 14 systems.

This ROS caveat, however, may be in jeopardy. Recently TrailBlazer Health Enterprises, the Part B Medicare carrier for Delaware, D.C., Maryland, Virginia and Texas has developed a supplementary guideline that will require the physician to comment on at least 10 systems individually to reach a complete review of systems. ACEP is monitoring this situation, and recommends you check with your local carriers and payers for their policies regarding the use of this caveat.

http://www.acep.org/practres.aspx?id=30474

There are two components to the TrailBlazer audit tool that worry physicians: It says that it won't give credit in the Review of Systems for cases where a physician discusses some systems and then writes "all other systems negative." Also, TrailBlazer has created a complicated points system for Medical Decision Making.



Emergency physicians, in particular, are very concerned that the audit tool isn't applicable to emergency medicine and will limit their ability to code 99284 or 99285 encounters. They point to the fact that they won't gain a point for "direct visualization," and that reviewing and summarizing old records and discussing the case with another provider are each only one point.



So far, no physicians have reported being audited using the new tool, but TrailBlazer has been defending its right to use it. And the Centers for Medicare & Medicaid Services stood up for TrailBlazer at the Nov. 3 physician Open Door Forum. Quinten Buechner with ProActive Consultants in Cumberland, WI asked CMS officials about the TrailBlazer policy, and they responded that carriers have a right to make their own policies...

http://medicalnewswire.com/artman/publish/article_7163.shtml
 
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I wouldn't worry...

Carrie,

As someone who has actually WRITTEN a text book on E/M, etc, I can tell you that your source for the 30% error comment is very likely bogus.

When you write a technical book, all sources of information must be cited, by chapter, and reported to the publisher. A fact-checker double-checks the data and so on. Professional "reviewers" are then employed to read the material and report back. Again, these are credentialed people in the field that get a pre-publishing look to prevent the dissemination of BS. If someone's published with an actual publisher, not self-published, then I'd feel comfortable.



After reading up on AAPC forum threads, I read someone saying that 30% of the coding books out there are wrong. That scared me.
I've been reading Joe Rivet's book entitled "Auditing Evaluation and Management Coding" and I'm wondering if anyone can vouch for this author. I want to make sure this book is not one of the bad ones!
Can anyone reccommend good resources for auditors?
What are the best credentials to have as a certified auditor?
Any advice would be appreciated!:)
 

cdcpc

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Thank you Belinda! Your advice on my thread (and on others) has been very helpful! :)
 

janice.moore

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Thanks Belinda. I didn't have the time to do a thorough search. Carrie, sorry I didn't get back to you.
 
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