Sylvia Lara
New
Hi, I have always coded for specialty practices. We recently took on a family practice office and the physician is very involved with how she codes her superbills. However, recently our hospital hired a consultant to audit her charts. They found that she has overcoded her 99204 and 99214 office visits.
She does provide a great deal of documentation, but lacks in her ROS and she personally feels that if she is following guidelines. She utilizes a worksheet that is uses points for her documenation.
And she feels that even if the patient comes in with a 1 exacerbated problem and 4 chronic problems; she can charge at a higher E/M code. I have been a CPC for 4 years and she wants me to audit her charges. I have never audited and am not sure what I should be reviewing. I know that we use the bullets to make sure the criteria has been met. She wants me to be more explicit than that and I can't answer her. Any information would be helpful to me, I have not felt so incompetent until this physician starting questioning and wanting me to show her exactly where in the book it states it.
She does provide a great deal of documentation, but lacks in her ROS and she personally feels that if she is following guidelines. She utilizes a worksheet that is uses points for her documenation.
And she feels that even if the patient comes in with a 1 exacerbated problem and 4 chronic problems; she can charge at a higher E/M code. I have been a CPC for 4 years and she wants me to audit her charges. I have never audited and am not sure what I should be reviewing. I know that we use the bullets to make sure the criteria has been met. She wants me to be more explicit than that and I can't answer her. Any information would be helpful to me, I have not felt so incompetent until this physician starting questioning and wanting me to show her exactly where in the book it states it.
