tci Medicare Compliance & Reimbursement - 2005 Issue 4

Physicians: Docs Kissed Nearly $1 Billion Goodbye In 2004

But the AMA doesn't want to tinker with E/M coding againPhysicians are losing thousands of dollars every day due to downcoded evaluation and management codes - and there's no relief in sight.The Centers for Medicare & Medicaid Services said most of the $1 billion in underpayments in 2004 came from physician visits. CMS performed a special undercoding study as part of its 2004 report on the Comprehensive Error Rate Testing program, issued in December. Meanwhile, E/M visits also account for a significant amount of downcoding.In the CERT report, CMS said it would ask the American Medical Association...

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