Health Information Management

News: OIG says physicians increased levels of E/M billing

CDI Strategies, June 7, 2012

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Over a nine-year period, from 2001 to 2010, physicians increased billing of higher level evaluation and management (E/M) codes in all types of E/M services, according to an Office of the Inspector General (OIG) report released in May.

Medicare payments for E/M services increased by 48%, from $22.7 billion to $33.5 billion, according to the OIG. The report found that approximately 1,700 physicians consistently billed higher level E/M codes in 2010. In addition, the OIG found that the physicians who consistently billed higher level E/M codes also treated beneficiaries of similar ages and with similar diagnoses than those treated by other physicians.
 
The OIG instructed CMS to continue to educate physicians on proper billing for E/M services, and to encourage Medicare contractors to review physician billing for E/M services.
 
Editor’s Note:For more information on CDI and its relationship to physician E/M, read ACDIS Advisory Board member Glenn A. Krauss, BBA, RHIA, CCS, CCS-P, CCDS, recent publication The Documentation Improvement Guide to Physician E/M.



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