Medicare ED bills show worrisome variations in hospital coding
Case Management Weekly, January 14, 2004
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More than a year after implementation of the Medicare outpatient prospective payment system (PPS), there are unexpected variances in the assignment of evaluation and management (E&M) codes on emergency department (ED) claims.
A recent study by American Hospital Directory (AHD) used hospital outpatient PPS claims to define normal Medicare payment levels and distributions of patients among various levels of (E&M) codes for calendar year 2002. Data for some hospitals indicate that there may be systematic undercoding or overcoding of ED encounters.
Retrieve the study at http://www.ahd.com for more information.
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