# Please help! FP Doc questions coding



## Sylvia Lara (Dec 10, 2007)

Hi, I have always coded for specialty practices. We recently took on a family practice office and the physician is very involved with how she codes her superbills. However, recently our hospital hired a consultant to audit her charts. They found that she has overcoded her 99204 and 99214 office visits.
She does provide a great deal of documentation, but lacks in her ROS and she personally feels that if she is following guidelines. She utilizes a worksheet that is uses points for her documenation.
And she feels that even if the patient comes in with a 1 exacerbated problem and 4 chronic problems; she can charge at a higher E/M code. I have been a CPC for 4 years and she wants me to audit her charges. I have never audited and am not sure what I should be reviewing. I know that we use the bullets to make sure the criteria has been met. She wants me to be more explicit than that and I can't answer her. Any information would be helpful to me, I have not felt so incompetent until this physician starting questioning and wanting me to show her exactly where in the book it states it.


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## mmelcam (Dec 10, 2007)

Try looking at this website...

http://www.msbcbs.com/emsr/

On the right you will see a link for E/M Documentation Auditors' Workseet.
This will give you a worksheet that auditors use when auditing charts. This is for the 1995 Guidelines. Hope this helps.


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## Sylvia Lara (Dec 10, 2007)

*Please Help!*

Melissa, thank you for responding so quickly. Have a Great Day!


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## Rhonda Buckholtz CPC (Jan 3, 2008)

Why not purchase the E/M auditors study guide? Even if you are not going to take the exam the book is a great reference source. Also, Medicare puts out a great E/M training book on the Medlearn site free of charge.


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## Sylvia Lara (Jan 3, 2008)

katie1241 said:


> GO TO THE SEMINAR ON MAY 15 2008 WHERE BONNIE BROWN WILL BE TEACHING E/M AND CHART AUDITING.
> 
> SHE IS THE MAN!! SHE CAN ANSWER YOUR EVERY QUESTION, SHE IS ALSO AN RN..SO THAT IS A BONUS.
> 
> ...



Katie, thank you for the information, I will check out the seminar. Thanks!


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## mcpalmeter (Jan 3, 2008)

*FP Doc questions coding*

Hi Sylvia,

I suggest you take an E&M course before beginning to utilize an audit worksheet.  You may want to read the Medicare Learning Network's Evaluation and Management Service Guide.

http://www.cms.hhs.gov/MLNproducts

Regards,

Maryann C. Palmeter, CPC


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## Terri Fleisch (Nov 22, 2008)

Hi:

I Need Help With Coding Workers Comp Cases.  We Provide Pt Services Mainly.  I Have No Experience Coding For Workers Comp And I Need As Much Info As You Can Give.  Please Help.

Thank You For Your Time And Consideration.

Terri


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