Coding Compliance Programs Gain Momentum

June 2002
Editorial
John W. McDaniel

If your responses to our April 2002 issue are an accurate gauge, physicians are taking an increased interest in developing compliance programs. Our cover article, “Aiming for Average: The First Step Toward Coding Compliance,” spurred a large number of inquiries from physicians who want to compare their use of evaluation and management (E&M) codes with the Centers for Medicare and Medicaid Services’ national audit standards. These standards, many of which can be found on our Web site www.Coding-Compliance.com), offer you an immediate opportunity to detect potential under-coding or over-coding.
In this month’s issue, we delve into documentation and chart audits, the second and probably most crucial component of a first-rate compliance program. Clearly, precise documentation is the key to good coding practices. As we’ve noted in the recent past, most physicians tend to under-code for the services they provide and over-code for what they have documented. The documentation step provides an important safeguard against lost income and government audits. Should the government look into your billing practices, the procedure also offers evidence that you’ve been making a conscientious attempt to submit accurate paperwork.
If you’re looking for some help in improving how you select your E&M codes or audit your charts, read about James Weintrub, a plastic surgeon and systems analyst in Providence, RI. In seeking a way to make coding easier to understand and manage within his own practice, he helped develop software that could well be useful to your practice, too.
Of course, don’t miss this issue’s cover story on preventive medicine codes. Often, when patients are seen for preventive medical services, the encounter is coded as an office visit by an established patient, which turns into a costly mistake. We also let you know what preventive services Medicare recipients are entitled to receive. For example, did you know that on January 1, 2002, Medicare began covering regular glaucoma screening? Preventive medical services are sure to remain an important topic. If you saw the March 2002 cover article, “Physician Coding Practices Face Intense Federal Scrutiny in 2002,” you are already aware that the government will be exploring beneficiary access to preventive services during fiscal year 2002.
As always, we appreciate your responses and welcome your questions.
With your help, we can continue to provide essential, up-to-the-moment information on coding compliance.

John W. McDaniel
Editor-in-Chief
Toll-free phone: 1-800-764-2633
E-mail: jmcdaniel@premierhealthcare.com