tci Medicare Compliance & Reimbursement - 2007 Issue 42

PART B MYTHBUSTER: Are Your Audits Making Your Coding Better Or Worse?

Find out before it's too late if your auditor knows the scoreMyth: Any coder can perform a chart audit.Reality: Your auditor should be someone who understands the clinical scenarios your physicians are dealing with. An auditor should also be aware that different carriers may use different audit tools.Your coder or biller should have a good working knowledge of Medicare's documentation and coding guidelines, especially for evaluation and management visits, says Catherine Brink, president of Healthcare Resource Inc., in Spring Lake, NJ. An auditor also needs to know the difference between the 1995 and 1997 E/M guidelines, and...

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