Evaluation and Management Coding Services

View Sample Report: E&M review

Evaluation and Management Coding Background

  • Directed by a nationally known Evaluation and Management coding and reimbursement expert who is both a certified coder and a certified instructor of coding.
  • 25 years experience coding for and training evaluation and management physicians to improve documentation and coding compliance.
  • Trained thousands of physicians how to improve medical record documentation E+M code selection, and over a hundred coders how to code evaluation and management services.

Evaluation and Management Coding Need

  • Evaluation and Management coding encompasses every clinical specialty and subspecialty. This makes Evaluation and Management algorithmically more complex, particularly for the Medical Decision Making component of Evaluation and Management coding. What works for one subspecialty does not apply to another. Specialty specific training and experience is critical.
  • Experienced and skilled Evaluation and Management coders are hard to find and can demand high salaries.
  • Few Evaluation and Management coders have the certified procedural coder designation, a symbol career commitment and of quality coding.
  • Coding guidelines for Evaluation and Management services are complex, change often and errors can be costly to the practice or create major compliance audit exposure.
  • Coder turnover creates cash flow peaks and valleys.
  • With so few coders specializing in Evaluation and Management coding, it is difficult to find and hire experienced Evaluation and Management coders, even in large metropolitan areas. Medical practices and hospitals in smaller communities and tight labor markets have trouble filling openings.

Evaluation and Management Coding Solution

  • TCN’s Evaluation and Management coding services address both inpatient and office professional charges and hospital outpatient clinics.
  • TCN’s Evaluation and Mangagement coders have specialty experience in:
    • Allergy and Immunology Evaluation and Management Coding
    • Cardiology Evaluation and Management Coding
    • Cardiothoracic Surgery Evaluation and Management Coding
    • Colorectal Surgery Evaluation and Management Coding
    • Dermatology Evaluation and Management Coding
    • Endocrinology Evaluation and Management Coding
    • Family Practice Evaluation and Management Coding
    • Gastroenterology Evaluation and Management Coding
    • General Surgery Evaluation and Management Coding
    • Geriatrics Evaluation and Management Coding
    • Gynecology Evaluation and Management Coding
    • Hematology-Oncology Evaluation and Management Coding
    • Hospitalist Evaluation and Management Coding
    • Infectious Disease Evaluation and Managment Coding
    • Internal Medicine Evaluation and Management Coding
    • Neonatology Evaluation and Management Coding
    • Nephrology Evaluation and Management Coding
    • Neurology Evaluation and Management Coding
    • Neurosurgery Evaluation and Management Coding
    • Ophthalmology Evaluation and Management Coding
    • Orthopaedic Evaluation and Management Coding
    • Otolaryngology Evaluation and Management Coding
    • Pain Management Evaluation and Management Coding
    • Pediatrics Evaluation and Management Coding
    • Pediatric Surgery Evaluation and Management Coding
    • Physical Medicine Evaluation and Management Coding
    • Podiatry Evaluation and Management Coding
    • Pulmonology Evaluation and Management Coding
    • Radiation Oncology Evaluation and Management Coding
    • Rheumatology Evaluation and Management Coding
    • Surgery Evaluation and Management Coding
    • Surgical Oncology Evaluation and Management Coding
    • Trauma and Burn Evaluation and Management Coding
    • Urology Evaluation and Management Coding
    • Vascular / Endovascular Surgery Evaluation and Management Coding
    • Wound Care Evaluation and Management Coding
  • Our certified and specialty-experienced Evaluation and Management coders will code your services within 2-to-3 workdays when sent consistently.
  • We will identify documentation deficiencies to help improve the quality of your medical records and optimize reimbursement.
  • Our volume-driven per-service pricing model is inexpensive and our team of coders stabilizes cash flow performance.
  • Reduce compliance audit exposure due to inadvertent coding errors or persistent errors by noncompliant physicians.
  • A practical and affordable solution for your Evaluation and Management coding needs to improve coding and documentation.

Evaluation and Management Coding Services

  • Temporary or ongoing Evaluation and Management coding coverage for all or part of your caseload.
  • Backlog coding resolution services.
  • Compliance and missed revenue audits.
  • Charge-ticket (“superbill”) updates and redesigns to stay current with coding changes.
  • Physician documentation and code selection training.
  • Physician group documentation deficiency reporting.
  • Coding helpline services.
  • Evaluation and Management coding “helpline” services.
  • OIG and RAC audit defense.

Payments for Evaluation and Management Services – Update from Office of Inspector General – Fiscal Year 2011 Work Plan Medicare Part A and Part B – Page 1 -14

We will review the extent of potentially inappropriate payments for E&M services and the consistency of E&M medical review determinations. CMS’s Medicare Claims Processing Manual, Pub. No. 100§04, ch. 12, § 30.6.1 instructs providers to “select the code for the service based upon the content of the service” and says that “documentation should support the level of service reported.” Medicare contractors have noted an increased frequency of medical records with identical documentation across services. We will also review multiple E&M services for the same providers and beneficiaries to identify electronic health records (EHR) documentation practices associated with potentially improper payments.

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Update: CMS’s Proposed Changes to the Physician Fee Schedule for 2019

October 17th, 2018|Comments Off on Update: CMS’s Proposed Changes to the Physician Fee Schedule for 2019

Following up on our September 4th, 2018 post “MGMA Opposes Proposal to Consolidate E/M Codes”, The Coding Network has been actively tracking the status of the sweeping changes to the Physician Fee Schedule for 2019 proposed […]

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Stuart Doctor Charged in Twenty-Six Count Federal Health Care Fraud Indictment

October 16th, 2018|Comments Off on Stuart Doctor Charged in Twenty-Six Count Federal Health Care Fraud Indictment

A specialist has been accused of submitting social insurance misrepresentation out of her training in Stuart, Florida. The U.S. Lawyer for the Southern District of Florida, Shimon R. Richmond, Special Agent in Charge, U.S. Division […]

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Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements

October 12th, 2018|Comments Off on Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements

OIG reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that did not have corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation to determine whether the services met Medicare’s requirements for […]

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Batesville Lady Blamed for Overbilling Medicaid for Preferred Family Health

October 10th, 2018|Comments Off on Batesville Lady Blamed for Overbilling Medicaid for Preferred Family Health

A previous charging assistant at Preferred Family Health has been captured on doubt of Medicaid extortion. Vicki Chisam, 65, of Batesville is blamed for purposely putting forth false expressions to the Arkansas Medicaid Program from […]