E&M Coding — Are You Under, Over, or on Target?

How does your practice’s evaluation and management (E&M) utilization compare with that of other practices in your specialty?

Virtually all commercial and managed care companies monitor physician practices’ utilization of E&M codes, which make up about 80 percent of the typical practice service base. Payers compare individual practices’ utilization with national benchmarks to help screen for fraud and abuse in the medical office.

Remember, specific documentation guidelines govern the use of E&M codes. Don’t simply adjust your E&M coding to match the national trend. Proper documentation must support the coding level for every patient encounter in your practice.

If you need help understanding E&M coding guidelines, contact TMA Practice Consulting at (800) 523-8776. A TMA expert can provide you and your staff on-site, hands-on training tailored to your practice, including how to audit your own records.

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Last Updated On

July 20, 2023

Originally Published On

March 23, 2010