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Please help! FP Doc questions coding

  1. Default Please help! FP Doc questions coding
    Exam Training Packages
    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.

  2. #2
    Location
    St. Louis, Missouri
    Posts
    262
    Default
    Try looking at this website...

    http://www.msbcbs.com/emsr/

    On the right you will see a link for E/M Documentation Auditors' Workseet.
    This will give you a worksheet that auditors use when auditing charts. This is for the 1995 Guidelines. Hope this helps.

    Melissa Blow, CPC

  3. Default Please Help!
    Melissa, thank you for responding so quickly. Have a Great Day!

  4. #4
    Default
    Why not purchase the E/M auditors study guide? Even if you are not going to take the exam the book is a great reference source. Also, Medicare puts out a great E/M training book on the Medlearn site free of charge.
    Rhonda Buckholtz, CPC, CPC-I, CGSC, COBGC, CEPDC, CENTC
    Vice President, ICD-10
    AAPC
    800-626-2633 ext 183
    814-673-7177
    Fax: 814-217-0447
    rhonda.buckholtz@aapc.com

  5. Default
    Quote Originally Posted by katie1241 View Post
    GO TO THE SEMINAR ON MAY 15 2008 WHERE BONNIE BROWN WILL BE TEACHING E/M AND CHART AUDITING.

    SHE IS THE MAN!! SHE CAN ANSWER YOUR EVERY QUESTION, SHE IS ALSO AN RN..SO THAT IS A BONUS.

    ANOTHER BONUS IS THAT THE SEMINAR IS ON A CRUISE SHIP TO MEXICO!

    GO TO www.educationalretreats.com TO CHECK IT OUT!
    Katie, thank you for the information, I will check out the seminar. Thanks!

  6. #6
    Location
    Jacksonville, Florida - 90417
    Posts
    187
    Default FP Doc questions coding
    Hi Sylvia,

    I suggest you take an E&M course before beginning to utilize an audit worksheet. You may want to read the Medicare Learning Network's Evaluation and Management Service Guide.

    http://www.cms.hhs.gov/MLNproducts

    Regards,

    Maryann C. Palmeter, CPC

  7. Default
    Hi:

    I Need Help With Coding Workers Comp Cases. We Provide Pt Services Mainly. I Have No Experience Coding For Workers Comp And I Need As Much Info As You Can Give. Please Help.

    Thank You For Your Time And Consideration.

    Terri

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