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Podiatry Coding & Billing Alert

Compliance:

Is Your Practice Leaning Too Heavily Toward High-Level E/Ms?

Published on Wed Jul 25, 2012

Warning: The OIG is scrutinizing your 99214 and 99215 trends -- make sure you are, too.If you examine your practice's E/M trend line, does your frequency of reporting high-level E/M codes increase dramatically over the years? If so, you should determine the reasons why, before your MAC begins forcing you to make that determination.A recent study by the Office of the Inspector General (OIG) found that physicians increased their billing of higher-level E/M codes across all categories (inpatient, outpatient, etc.) between 2001 and 2010. In fact, the OIG sent CMS a list of 1,700 physicians who were identified as "consistently billing higher-level E/M codes in 2010." The report results were summarized as follows by the OIG in its report, "Coding Trends of Medicare Evaluation and Management Services," which was published on May 9.Outpatient: For outpatient services, the report noted that a shift was seen "in billing from the three lower-level E/M [...]
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