tci Medicare Compliance & Reimbursement - 2006 Issue 36

HOSPITALS: Prepare For Imminent Audits Of ED Visits

Physicians' emergency department visits could be under more security soon.A recent survey by the American Hospital Directory showed that evaluation & management (E/M) levels reported in the ED have increased in the past few years. For example, 24 percent of visits were level four in 2004, compared with only 20 percent in 2002. Experts offer physicians two key tips for dealing with ED E/M audits:1. Make sure that any auditor understands ED coding. There are a few important differences between E/M services in the ED and elsewhere, says David McKenzie, CAE, director of reimbursement with the American College...

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