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Documentation Guidelines

  1. #1
    Question Documentation Guidelines
    Medical Coding Books
    We recently implemented the 1995 DG's with our providers for better compliance and to increase revenue. In the meantime, the company purchased an EMR that calculates the level of service based on the 1997 DG's. The software company is telling us they have no plans to customize their product for the 95 DG's because they are under the impression CMS will abandon the 95 DG's when ICD10 is implemented. Has anyone heard this or have any references for verifying?

  2. #2
    Location
    Evansville Indiana
    Posts
    451
    Default 1995 guidelines
    It is advised not to let the EMR determine E&M level because there is such a danger of over/under coding, so it wouldn't really matter which guidelines the system uses.
    LeeAnn

  3. #3
    Location
    Kansas City, MO
    Posts
    434
    Default
    Quote Originally Posted by cheermom68 View Post
    It is advised not to let the EMR determine E&M level because there is such a danger of over/under coding, so it wouldn't really matter which guidelines the system uses.
    LeeAnn
    I agree. Ours gives us the option of using either 95 or 97. The doctors caught on to the fact that when they changed it to 95 their codes were higher. We find that the system overcodes a lot.

    To answer your question, no, I have not heard of the 95 guidelines going away.
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC,CCC, AAPC Fellow
    PMCC Licensed Instructor
    2018 Chapter President, Kansas City, MO

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