News & Press: Advocacy

Coding Audits of E&M Services

Thursday, September 20, 2012  
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CMS has announced that it has approved the Medicare Region C Recovery Auditor(RAC) to begin conducting audits of coding for E&M services in physician offices, specifically CPT code 99215.  The RAC will be permitted to extrapolate their findings based on a statistical sample of such claims.

The selected contractor performs audits in AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, SC, TN, TX, VA, WV, Puerto Rico and the U.S. Virgin Islands. These reviews are expected to begin imminently in Region C and, according to CMS, are likely to be approved in other Medicare regions in the near future. 

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