Evaluation and Management codes are often vulnerable to third-party auditor scrutiny. Payers frequently use different types of analyses to identify outliers with E/M coding, such as physicians who bill higher-than-normal levels of more intensive codes. Other auditors, such as Recovery Auditors, Medicare Administrative Contractors, and Zone Program Integrity Contractors often follow the same process to use this same type of data to calculate from analytics.
Given the increased scrutiny of these codes, it's important to be confident with E/M and other coding that it is reflective of the accurate documentation during the patient encounter.
During this webinar, we will revisit E/M coding guidelines and other top office services for Behavior Health professionals. There will be sample scenarios used during the webinar to help define the reason for the patient encounter documentation requirements that meet the definition of the code.
Why should you Attend: According to the CMS documentation audit tool, medical necessity is the overarching criterion in determining the level of service to bill, along with the individual requirements of a particular CPT code.
It would not be appropriate to document and bill a higher level of service when a lower level of service is warranted. Nor should the volume of documentation be the primary influence for which level of E/M service is billed.
Due to increasing audits with E/M coding and documentation, each provider should be asking the question, "Does my documentation truly justify the services rendered, and are those services medical necessary for the diagnosis treated?
Areas Covered in the Session: