General Surgery Coding Alert

You might be committing fraud. Have you ever selected a lower-level evaluation and management (E/M) code than your surgeon deserves because you want to make sure your claims will stand up to an audit? You're not alone, apparently, since national insurer data shows that physicians downcode E/M claims to the tune of more than $1 billion annually. Let our experts show you three good reasons to stop undercoding your surgeon's E/M services. You Might Actually Trigger an Audit If you think that avoiding upper level E/M codes will keep the auditors away, think again. When claims reviewers look at "bell curves" to determine whether your practice is coding outside the norm, they're not just looking at high-level examinations. Auditors are looking for trends across the board, so a practice with mostly 99212s (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least [...]