Expand


Go Back   AAPC Forum > Auditing > General Discussion
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 03-21-2014, 08:07 AM
cswan cswan is offline
Networker
 
Join Date: Apr 2007
Posts: 25
cswan is on a distinguished road
Default Limiting the E/M codes on a superbill

I'm wondering if anyone has a reference regarding the limiting of E/M codes on a superbill/encounter form?

Once upon a time, I was told that if the E/M CPT codes are limited on the superbill, it can be interpreted to be 'directing' the provider to only choose those codes. Example: For Inpatient care, only the 99222 and 99223 are listed on the superbill. Leaving off the 99221 can look like the provider is being 'pushed' to choose a higher level.

I know this is not good business practice to limit them on the superbill, and of course, providers need a reference, so I would really appreciate any help on this.
Thanks, everyone!
Cindy L. Swan, CPC CEMC
Reply With Quote
  #2  
Old 03-21-2014, 12:58 PM
terif terif is offline
Contributor
 
Join Date: Apr 2007
Location: Norwich
Posts: 23
terif is on a distinguished road
Default

I was told the same thing by an auditor a few years back. We use 99211, 2, 3, etc and it works.
__________________
Teri Fournier, CPC
Reply With Quote
  #3  
Old 03-22-2014, 09:40 AM
MarcusM MarcusM is offline
Expert
 
Join Date: Apr 2007
Location: Austin, Texas
Posts: 464
MarcusM is an unknown quantity at this point
Default

The provider should have each level for new and established codes for their decision making process without any subjective bias.
Reply With Quote
  #4  
Old 03-24-2014, 08:44 AM
cswan cswan is offline
Networker
 
Join Date: Apr 2007
Posts: 25
cswan is on a distinguished road
Default Limiting the E/M codes on a superbill

Right! Thank you for the confirmation. It would be really great if there was a reference out there....so if anyone has one, please let me know. I will keep looking.
Thanks!
Cindy L. Swan CPC, CEMC
Reply With Quote
  #5  
Old 03-24-2014, 09:09 AM
mitchellde's Avatar
mitchellde mitchellde is offline
True Blue
 
Join Date: Apr 2007
Location: Columbia, MO
Posts: 10,077
mitchellde will become famous soon enoughmitchellde will become famous soon enough
Default

Several years back there was an OIG case regarding auditing for the E&M levels. In the write up
They stated that upon review of the superbills several of the providers were fined due to only representing the highest levels. You may still be able to locate this on the OIG website or try a google search.
__________________

Debra A. Mitchell, MSPH, CPC-H
Reply With Quote
  #6  
Old 03-24-2014, 09:43 AM
cswan cswan is offline
Networker
 
Join Date: Apr 2007
Posts: 25
cswan is on a distinguished road
Default

Wow...thanks for the information. I will go search the OIG right now!
Cindy
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 09:30 PM.


Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2015, Jelsoft Enterprises Ltd.
Copyright ©2015, AAPC