Wiki General Surgery E&M

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drhoads

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Can anyone tell me if there is a different type of audit grid, other than the Trail Blazer, for auditing general surgery E&M office visits. I am particularly interesed in the exam section. The physician feels the 1995 and/or 1997 guidelines do not fit his speciality. Any help is greatly appreciated. Thanks!
 
E&M is E&M, regardless of the specialty...but that's why the 97 guidelines were designed....to create specialty-specific exams. There are other audit tools published by other regional contractors, but generally they're all based on CMS's guidelines. If Trailblazers is your carrier, then you really should use their guidelines.

I've found that by working with our providers, showing them the audit tool and the 95 and 97 guidelines, and helping them determine the most effective way to document their 'standard' exam, they can obtain the higher level services for their more complicated cases. A good example of how to accomplish this is demonstrated at E&M University. www.emuniversity.com
 
Thank you that was my thought also. Just wanted to double check if I was missing anything, since my doctor was upset over his last audit review. He faired better when I used the 1995 guidelines instead of 1997. Would you agree this is the case most of the time, using 1995 instead of 1997? Thank you.
 
I think that the 95 guidelines are more beneficial for most specialties. One specialty that fares bettere with '97 are psychiatrists. You just have to audit both ways and see how you do.
 
General Surgery ASC Audit Tool

Does anyone currently use an Audit Tool for their ASCs when doing Audits? If so are you willing to share your templates?
 
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