Optum360Coding.com
    Contact Us   (7 a.m.–7 p.m. CST)
  Home > Coding Central Articles > Coding Central Articles  
Coding Central
Coding Central Home
Inside Track to ICD-10
Coding Central Articles
Code This!
Case Studies
Chargemaster Corner

Articles for:
February 9, 2017


Where to train: E/M coding has the biggest return on investment

Studies conducted by CMS show that E/M services are very prone to problems, namely insufficient o... Learn More


February Coding Corner
In the Optum360 Coding Corner, we highlight areas in which medical coding professionals are struggli... Learn More

Providers Not to Be Penalized for Quality Measures Affected by ICD-10 Update

In December 2016, the Centers for Medicare and Medicaid Services (CMS) announced that it would no... Learn More


View Article Archive

Subscribe:
To subscribe, paste this link into your preferred feedreader, or click on one of the buttons below:
 

Medical Coding News

Where to train: E/M coding has the biggest return on investment

 
February 9, 2017:

Studies conducted by CMS show that E/M services are very prone to problems, namely insufficient or no documentation, over coding and under coding. Further, a recent study by a Medicare carrier found error rates as high as 44% for some E/M services.

What’s the problem with E/M coding? Simply, coders and clinicians who code have trouble selecting the correct code from among a range of seemingly appropriate choices, given the documentation in the record. The resulting high error rates make E/M coding the most appropriate place for investing in education and training.

Incorrect coding for E/M services Error rate
Office/outpatient visit, est. (99214) 5.50%
Subsequent hospital care (99233) 16.80%
Office/outpatient visit, est. (99215) 18.60%
Office consultation (99244) 17.50%
Initial hospital care (99223) 12.70%
Inpatient consultation (99254) 15.50%
Subsequent hospital care (99232) 3.50%
Office/outpatient visit, est. (99213) 1.70%
Inpatient consultation (99255) 17.70%
Office/outpatient visit, new (99204) 20.80%
Office consultation (99245) 19.10%
Office consultation (99243) 9.60%
Emergency dept. visit (99285) 5.40%
Office/outpatient visit, new (99203) 10.40%

Some E/M services have the most improper payments of all billed services.

Source: Improper Medicare Fee-for-Service Payments, May 2008, CMS



E/M services are the most frequently reported clinical services to any payer, in addition to being the biggest contributor to practice revenue for most specialties.

What’s the best investment for E/M coding improvement? Consider the 2017 Evaluation and Management Coding Advisor. This manual is designed to ensure appropriate code selection and determine if the medical record supports the level of E/M selected.

Key features include:

  • Review of every E/M service
  • Clinical vignettes that illustrate real-life coding issues
  • Multiple-choice exams for each E/M segment; answer rationale explains why the answer is the most appropriate choice
  • Concise, thorough documentation requirements for all E/M codes

For more information about the 2017 Evaluation and Management Coding Advisor, visit https://www.optum360coding.com/Product/46261/.

 

 

Sign in to
Your Account

USERNAME
Forgot your username?
PASSWORD
Forgot your password?
Don't have an account?
It's easy to create one.

Promo code

Have a promotional source code? Enter it here:


What is this?

Code This!

Test your coding knowledge!

/VIEW MORE