• Audit Rules Postponed - But the "traffic cops" are ready to catch those in noncompliance.
• Highest Specificity - Always select a code from the highest specificity column.
• The Internet & You - The best sites available to Primary Care providers.

Evaluation and Management Guidelines scheduled for implementation / enforcement on July 1, 1998 have been postponed again. It now appears that it could happen sometime this Fall, or even later.

In 1776 our country had a revolution. It was centered against repression from a foreign power. The documented complaint against King George of England was that he had "sent swarms of officers to harass the people and eat out their substance".

There are two sides to the E/M Guideline enforcement issue. One is from the "officers" who are only trying to do their job. The other is from the "providers" and doctors who are feeling the probable impact of the coming reality and "harassment".

In the Fall of 1996, during an AMA Symposium on Coding, I sat at the luncheon tables and discovered that many of the attendees had recently been hired by government agencies. It was blatantly apparent that they were preparing well for the coming Fraud & Abuse Wars. Are you as well prepared?

The first battles commenced in 1997 with big fines and repayments from teaching hospitals and mega corporations. Groups and solo providers are next.

In summary, the Revised Documentation Guidelines for Evaluation and Management Services from the Health Care Finance Administration (HCFA) and the AMA, are being revised and refined again. If and when they finally go into effect, it will have a major impact. Document according to the guidelines. The "traffic cops" are ready to catch those in noncompliance.

Take advantage of all education and training seminars for your specialty or discipline. Will you be documenting Single Organ System Examinations or Multi-system Examinations? Decide and prepare.

-- D Henry Leavitt

Here's a little reminder about highest specificity and InstaCode ICD-9 Software.

Third party payors, especially Medicare, require the highest level of specificity for payment. Claims are rejected when those extra digits are not there.

Always select a code from the second column -- we call this the highest specificity column. This unique coding convention allows you to look in the same place every time whether there are three, four or five digits. There is no need to search for the required additional digits because anything listed in the second colum is the highest specificity.

Remember, that first column is NOT billable -- the second column is!

Considering that entire books have been written about the Internet and Medicine, please keep in mind that this article is only a brief synopsis.

Surfing the Internet is rewarding when you find that one source of information for which you have been searching. It can also be frustrating when you can't find what you want or get where you want to go.

We did extensive research to try to find some of the best sites available for Primary Care providers. Our sincere thanks to all contributors.

Of the numerous websites devoted to healthcare, some are more valuable to patients or particular diseases than providers. We listed some interesting sites for you and also some that could be helpful to pass on to your patients. All sites will be listed on our web site for easy access.

If you have a favorite site not listed, please give us a call or send an email to techsup@instacode.com

Click here to view the list of sites.

InstaCode's Quick & Easy Quarterly Newsletter is published for the exclusive use of InstaCode Institute friends and clients. Any decisions based upon this information are the sole responsibility of the reader and users.

© Copyright 1998, InstaCode Institute, LC - All rights reserved.