Auditing Evaluation and Management Coding: A Step-by-Step Guide to Enhancing your Practice's revenue and Compliance / Edition 1

Auditing Evaluation and Management Coding: A Step-by-Step Guide to Enhancing your Practice's revenue and Compliance / Edition 1

5.0 2
by Joe Rivet, Sharon Bolarakis
     
 

ISBN-10: 1578398150

ISBN-13: 9781578398157

Pub. Date: 05/01/2007

Publisher: HcPro

Your physicians bill evaluation and management (E/M) codes every day. E/M coding is an essential part of your practice's revenue cycle and it's also on the Office of Inspector General's (OIG) hit list. This means that it's more important now than ever to accurately report these codes. Conducting an E/M audit will help your practice enhance its revenue and stay under

Overview

Your physicians bill evaluation and management (E/M) codes every day. E/M coding is an essential part of your practice's revenue cycle and it's also on the Office of Inspector General's (OIG) hit list. This means that it's more important now than ever to accurately report these codes. Conducting an E/M audit will help your practice enhance its revenue and stay under the OIG's radar. Turn to Auditing Evaluation and Management Coding: A Step-By-Step Guide to Enhancing Your Practice's Revenue and Compliance for the expert advice and guidance you need to perform an E/M audit at your practice. Written by Joe Rivet, CPC, CCS-P and Sharon Bolarakis, CPC, this easy-to-follow book and CD-ROM guides you through the entire E/M audit process from start to finish. With it, you'll have all the tools, templates, policies, and procedures you'll need to establish a quality E/M audit program at your practice.

Product Details

ISBN-13:
9781578398157
Publisher:
HcPro
Publication date:
05/01/2007
Pages:
110
Product dimensions:
8.30(w) x 10.90(h) x 0.40(d)

Table of Contents


About the authors     vii
Introduction     xi
Importance of auditing E/M codes     xi
Common auditing errors: What you may see when auditing your practice     xii
E/M-related resources     xii
E/M guidelines: 1995 vs. 1997     xiv
From an auditor's view: Documentation essentials     xiv
Administrative buy-in     xv
How this book will help you     xvi
How this book is organized     xvi
How to use the CD-ROM     xvii
What's included on your CD-ROM     xviii
Acronyms used in this book     xix
Continuing education instructional guide     xxi
Choosing an E/M code     1
E/M code components     2
Consultations     18
Test your knowledge     21
Performing a risk assessment     23
High-risk areas to monitor     24
Five steps to include     26
Risk data categories     29
Items that can affect risk     30
Test your knowledge     32
E/M audit structure     33
Getting started     33
Choosing an auditor     34
Preaudit preparations     35
Deciding when to audit     38
Establishing a baseline     39
Tracking audit results     42
Auditing teaching physicians     43
Establishing an audit cycle     43
Scoring providers using a matrix     44
Other audit considerations     47
Test your knowledge     49
Using an audit tool     51
Sample medical record documentation     51
History     52
Exam     56
Medical decision-making     60
Final audit results     66
Test your knowledge     67
Packaging your audit     69
Audit reports to include     70
Additional documents to consider     72
Test your knowledge     73
Devising a compliance plan     75
Plan overview     75
Audit policy/procedure     76
New provider orientation     76
Outlier providers     78
Ongoing education     79
Test your knowledge     84
Answers     85
Sample medical record examples     93
New patient office visits (codes 99201-99205)     95
Established patient office visits (codes 99211-99215)     101
Consultation office visits (codes 99241-99245)     105

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Auditing Evaluation and Management Coding: A Step-by-Step Guide to Enhancing your Practice's revenue and Compliance 5 out of 5 based on 0 ratings. 2 reviews.
Anonymous More than 1 year ago
Excellent resource. A must have.
Anonymous More than 1 year ago
This book is perfect for any coding compliance department or physician practice. It has all the tools and guidance at your finger tips. The authors are nationally known in the industry and really make this difficult topic very clear.