Contact Us About Us Jobs Coding Helpline Home
Anesthesia Coding Pain Management Surgical Specialty Coding Emergency Medicine Coding Radiology Coding Pathology Coding Hospital Facility Coding ASC Coding Evaluation and Management Coding


Free Medical Coding Analysis

To get a free coding analysis, send us a sample of your medical or operative reports, along with copies of your claims for those cases. Our coder for your specialty will evaluate them and prepare a comparative analysis of your coding.
Please click here to order your free coding analysis.

Evaluation and Management Coding

Pricing requests.
Order service.
Order a free coding analysis.
What is E-Web coding?


How outsourced coding works.
Physician Documentation Training.
Audits and quality reviews.
Partial client list.
Who needs TCN?

 

Evaluation and Management Coding

Please review our evaluation and management coding compliance example and let us know if you have any questions.


Patient

Doctor

Original RBRVU

TCN ’s RBRVU

Difference in
RBRVU

Unbundled

Missed Procedure

Billed but
Not Done

Up-coded
E&M

Down-coded
E&M

Wrong Procedure
Code

Modifiers

Documentation
Deficiency

DX

 

 

15.33

12.27

3.06

 

X

X

 

 

 

 

X

XXX

 

 

3.21

2.09

1.12

X

 

 

 

 

 

 

 

6X

 

 

3.21

2.09

1.12

X

 

 

 

 

 

 

 

XXX

 

 

2.09

2.09

0

 

 

 

 

 

 

 

 

XXX

 

 

2.09

2.09

0

 

 

 

 

 

 

 

 

XX

 

 

2.09

2.09

0

 

 

 

 

 

 

 

 

XXX

 

 

3.33

1.88

1.45

 

 

X

 

 

 

 

 

XXX

 

 

3.75

3.75

0

 

 

 

 

 

 

 

X

 

 

 

1.47

2.09

-0.62

 

 

 

 

X

 

 

 

XXX

 

 

2.55

1.88

+0.67

 

 

 

X

 

 

 

 

XXX

TOTALS

Cont.

Cont.

Cont.

 

 

 

 

 

 

 

 

 

Positive Difference in RBRVU means original coding overvalued the case.

 

Patient: xxxxxxxx, F.

Date of Service: 5/20/03

Physician: xxxxxxxxxx

Original Coding RVU’s

 

99213 ............................... 1.39

Total .......................... 1.39

The Coding Network Coding RVU’s

 

99214 ............................... 2.17

Total ............................... 2.17

Difference .................... -0.78

Discussion

  • Downcoded E&M:

Documentation supports a higher level of E&M service.
Requirements for CPT 99214 were met.

  • Documentation Deficiency:

State that the patient is still under observation.

Diagnoses

255.0

285.8

593.9

 

Diagnoses

286.9

285.9

593.9

 

Discussion

  • Incorrect Diagnosis X2:

The medical record does not state the patient has
Cushing’s Syndrome. Do not code ICD 255.0.
Additionally, assign ICD 285.9 for anemia NOS
rather than 285.8, other specified anemia.

  • Missed Diagnosis:

Failure to assign ICD 286.9 for iatrogenic coagulopathy.

Medical Coding-Certified CPT, ICD9 & Surgical Coders Surgical Coding Emergency Medicine Coding
Radiology Coding Pathology Coding Hospital Facility Coding ASC Coding Evaluation & Management Coding
©2003 Coding Network. All rights reserved.