Evaluation and management (E/M) services occur in the hospital as inpatient or observation visits. They also occur in nursing homes, physicians’ offices, emergency departments and even in the home. While there have been guidelines since 1995 and guidelines updated in 1997, both of which are still used, E/M services still have been vulnerable to fraud and abuse. In 2021, major … Read More
There are often unintentional disconnects between AR and HIM, as coders focus on coding guidelines, medical necessity, and supportive documentation, but may not be aware of specific written payer instructions, payer manuals or unique contracts. This not only can create unnecessary denials or improper code changes, but it also can result in tensions between the two departments. Read the article.