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Thread: Overwhelmed.. Advice new auditor

  1. #1

    Default Overwhelmed.. Advice new auditor

    AAPC: Back to School
    Hello All. I am looking for any advice, tips, books, classes.

    I have worked 13 years in a sepcialty practice I used 97 guidelines only and our Doc's were well trained on E/M. major part of my job was coding surgery.
    NOW I have taken a job in a compliance dept and have just been handed 100 E/m visits to audit for a specilaty I have no idea about. I reviewed several notes and and I getting stuck on MDM and HPI of all things.. Is there any helpful info out there so that I can refresh myself on the E/M. It took me hours to code 10 visits.....

  2. #2
    Join Date
    Apr 2007
    Daytona Beach, FL


    I too have found myself having to audit E/M visits for various specialties and hospitalists in my new position. I have accessed the E/M guidelines from CMS or your local Medicare which is very helpful. Also, Highmark, our MAC has webinars which are helpful as a refresher course.

    The other resource I have used which is very helpful is emuniversity.com. This site has alot of E/M info and also a free Basic E/M course you can take. I have not taken it yet - I am waiting until June 1 so that I can use the CEU toward my next 2 year period, but I find that the weekly coding examples are quite helpful. He does alot of coding using the 97 guidelines (I have always used the 95 guidelines and have a hard time with the 97 guidelines.)

    Hope this helps. Good luck!

    Jodi Dibble, CPC

  3. #3



    I strongly recommend on the site - https://www.emuniversity.com/

    You can also use - 1. http://www.cms.hhs.gov/MLNEdWebGuide/25_EMDOC.asp
    2. ED Coding Alert's E and M Guide
    3. http://www.trailblazerhealth.com/ - go to Evaluation and management under Quick links.
    4. http://www.billdunbar.com/emergency-medicine/ - for new updates on ICD and CPT changes every year

    Hope this helps you.

    Thank You,

    Purnima S, CPC

  4. #4


    "I reviewed several notes and and I getting stuck on MDM and HPI of all things.. Is there any helpful info out there so that I can refresh myself on the E/M. It took me hours to code 10 visits"

    I find the Table of Risk from the 1995 or the 1997 Guidelines to be especially helpful when I'm stuck on MDM. Don't overthink it! Have a little faith in yourself and your abilities; you've been doing this for 13 years.

    Networking is great; when I get stuck on anything, I can normally Google the phrase I'm stuck on and most of the time, it leads me to the AAPC forums for the answer! We've got a great group here to help you.

    Good luck and congratulations on your new position! See you round the board. Susan R, CPC, CPMA, CEMC
    Last edited by Susan R; 05-27-2010 at 10:46 PM. Reason: spelling

  5. #5
    Join Date
    Apr 2007
    Scottsbluff Nebraska


    I really like the E/M University site also. He has alot of great information and good explainations of how he arrived at his levels of service.

    I have designed a great auditing tool that has been really helpful for the auditing department and also for our physicians. If you are interested just let me know and I can email it out to you!

    Good luck! It gets easier everyday!


  6. #6


    If you want to make your life a little easier, I would recommend purchasing an electronic audit tool. We use Intelicode but there are others out there. The audit tool is quicker and more accurate than trying to calculate everything by hand; plus, it prints a report for the physician to review. This is not only a time saver but it supports your compliance efforts.

  7. #7
    Join Date
    Apr 2007


    I have found the 2010 Advanced Coding Education Guide for Evaluation and Management Auditing book published by Decision Helath to be an excellent tool. The ISBN# is 978-1-933806-84-6.

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