tci Part B Insider - 2010 Issue 37

Self-Audits: Your Audits May Be Making Your Coding Worse, Not Better

Does your auditor know the score? Find out before it's too late.Myth: 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, experts say.An auditor also needs to know the difference between the 1995 and 1997 E/M guidelines, and understand the ins and outs of common procedures in...

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