Auditing Physician Services: Verifying Accuracy in Physician Services and E/M Coding to Protect Medical Practices, 2nd Edition

Take the steps to audit your practice...before the Government or Third-Party Payer does! A line-by-line update to the book including these "New" Sections for the 2nd Edition: Transitional Care Management (TCM) Chronic Care Management (CCM) EHR Cloning and Copy-Paste Over-documentation The key topics covered include a welcome amount of in-depth coding information -- topics and activities that practices perform every week. Protect your practice from governmental and third-party payer audits! This book explains complex reimbursement and coding rules and provides audit sheets for key, high-risk areas including E/M services. Today, medical practices face major risks if they don t code physician services accurately. Practices that violate the complex government regulations governing coding may face audits by the Office of the Inspector General for HHS, Recovery Audit Contractors and Medicare Administrative Contractors, and the consequences of such audits can be severe. However, physicians and their staff now have a comprehensive guide available which helps practices audit high-risk areas themselves, before payers get involved. Auditing Physician Services: Verifying Accuracy in Physicians Services and E/M Coding To Protect Medical Practices, written by nationally-renowned coding and auditing expert Betsy Nicoletti, MS, CPC, offers critical information, support and plain-English explanations of how to avoid high-risk coding behavior. Auditing Physician Services, provides clear, practical, concrete explanations of complicated coding issues and E/M guidelines, advice on auditing EMR notes, and a range of worksheets allowing physicians to conduct valid, defensible audits. The book also includes a detailed analysis of the 2015 OIG Work Plan which offers insight into how the agency selects physician practices for further review. TABLE OF CONTENTS Medical Practice Compliance and the 2015 OIG Work Plan Chapter 1: General Principles of Medical Documentation Chapter 2: Aberrant Evaluation and Management Coding Patterns Chapter 3: How to Audit Evaluation and Management Services Chapter 4: New Patient Visits Chapter 5: Consultations Chapter 6: Critical Care Services Chapter 7: Billing for 99211 Chapter 8: Incident To Billing and Shared Visits Chapter9: Use of Modifier25 Chapter 10: Billing for E/M Services During the Global Period Chapter 11: Initial Preventive Physical Examinations and Annual Wellness Visits Chapter 12: Teaching Physician Rules Chapter 13: Care Plan Oversight Chapter 14: Transitional Care Management (TCM) and Chronic Care Management (CCM) Final Thoughts Appendix 1: E/M Documentation Auditing Worksheet Index