tci Part B Insider - 2011 Issue 18

E/M Coding: Answer the $56 Question--Are You Downcoding Your E/M Visits?

You're not only losing revenue--you're also coding improperly.CMS data from previous years shows that medical practices undercode E/M claims to the tune of over $1 billion annually--that's money that physicians could have collected based on their documentation, but forfeited because they reported a lower-level code than they should have. But remember that your responsibility as someone who submits claims to Medicare is to code based on the documentation-- anything else is incorrect coding.If you're one of the practices that's downcoding claims, take note of the following reasons that you should code based on your documentation rather than...

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