Hi, I ’m an Attending and I am READY to Complain About Billing.

I barely knew anything about billing before becoming an attending – the only tidbits I knew were: 1) there are levels 2) gotta have a certain number of systems in your ROS with at least 2 specifics per system 3) the reason I document “fundoscopic exam: unsuccessful” in a 7 month old instead of deleting the line like a sensible person who understands 7 month olds has something to do with min-maxing billing, and 4) ED charts say “MDM” a lot. These are the charts our coders gave me during my 10 minute billing orientation: So that’s good – theoretically I should be able to just consult the horoscopes augheries billing charts and see what level I can bill for based on what I had time to document in my note, right? Except “Medical Decision Making” seems to supersede everything and is apparently totally derived from how many tests I order and how many prescriptions I give, rather than how much thought I put into NOT ordering extra tests and unnecessary drugs. It’s outrageous, really: you could meet every criteria for a Level 5 visit on those charts, but if the auditor thinks that your Medical Decision Making was ‘uncomplicated’ (meaning either your conclusion was that the pt was at minimal / low risk of imminent death, and / or you didn’t order more than 1-2 tests or prescriptions) then they will downgrade your whole beautiful 5 page note to a Level 2 visit and ding you for overbilling. OR you could jus...
Source: Action Potential - Category: Universities & Medical Training Authors: Tags: Uncategorized Source Type: blogs