tci Medicare Compliance & Reimbursement - 2007 Issue 38

The 3 Deadly Myths That Could Be Hindering Your E/M Chart Audits

Experts advise you to focus on your evaluation and management visits to reap the biggest rewards from chart audits. But here are three myths that could hold back your E/M audits:• All insurers audit using Medicare's guidelines. In fact, insurers may have their own criteria and you should be prepared for each payor's requirements, says Suzan Hvizdash, physician educator for the University of Pittsburgh Physicians Department of Surgery. Likewise, you shouldn't assume all insurers use the Marshfield Clinic's evaluation and management visit audit guidelines.• You have to pick either the 1995 or 1997 guidelines to audit E/M charts...

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