Evaluation and Management

Miscoded Evaluation and Management Services Cost Medicare $6.7 Billion

Medicare, Medicaid & Private Payor Updates /

(June 25, 2014) Officials at the Department of Health and Human Services, Office of Inspector General (OIG) recently examined medical records from 2010 for claims related to evaluation and management services (E/M services). The results are astounding. OIG determined that Medicare inappropriately paid $6.7 BILLION for E/M services that year due to claims that were […]

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Texas Providers Should Expect Increase in Postpayment Audits of E/M Claims.

Medicare, Medicaid & Private Payor Updates /

(March 8, 2011): In February 2011, TrailBlazer Health Enterprises (TrailBlazer) reported the results of “widespread ” probe reviews the contractor conducted of CPT Codes 99211–99215 related to Evaluation and Management (E/M) claims billed for dates of service 01/01/10 through 06/30/10. The frequency of E/M audits directed at Texas Medicare providers are increasing. Is your practice

Texas Providers Should Expect Increase in Postpayment Audits of E/M Claims. Read More »