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| Managed Care Contracting and Reimbursement Advisor |
| April 2008 |
| Conduct E/M coding audit to ensure compliance, enhance practice revenue |
| Editor's note: In the first article of a two-part series, MCCRA talks to coding experts about the use of internal coding audits to assess their readiness for an external audit and prevent the leakage of revenue. Part two will discuss training physicians and staff members to improve coding.
A coding audit is a terrific tool for physician practices to spot deficiencies in their claims submissions, especially for E/M codes. Identifying shortcomings in coding is important for two reasons.
First, the OIG expects healthcare providers to ensure that claims they submit to federal healthcare programs, such as Medicare and Medicaid, are accurate. Second, systematic undercoding by one or more providers leads to revenue shortfalls for physician practices. |
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