Undercoding is leaving piles of money on the table: report

by: Richard Scott Jan 19, 2016

In 2015, providers undercoded their way out of $1.2 billion, a large portion of which was tied to underreporting established-patient office visits related to E/M codes 99211-99215.

A CMS round-up of fee-for-service payment errors shows that downcoding -- or the reporting of a lower level code (i.e., 99213) when a higher level code (i.e., 99215) is appropriate -- is a problem that besets physician practices nationally, Part B News reported in its Jan. 18 issue.

Are you a serial downcoder? Consider the tip below to improve your coding accuracy and give your revenue a boost:

Conduct recurring peer reviews to ensure consistency. Experts advise that you have a physician review a couple of charts of his or her colleague and let the reviewing physician decide how to code the visit given the details present. Doing so will be instructional for both the reviewing physician and the physician who wrote the original chart.

For more tips read the full story, Code E/M established visits to the correct level to avoid a money drain.

Blog Tags: CMS, E/M services, provider compensation

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