The Coding Audit

You need two out of three components to code a 99213. Understand, this has nothing to do with the quality of medical care. The reality is that HCFA [the Health Care Financing Administration] will reclaim fees paid for inaccurate coding.”

A pile of my audited charts was arranged in front of the coding consultant. Next to her sat our billing specialist. It was 8:30 on a Thursday morning, in the middle of the half hour that I usually reserve to think, dictate letters, read about my difficult cases, and perform the myriad tasks that pile up by the end of the week. I understood that our group had actually requested this review. The mastery of evaluation and management codes was as much a requirement for medicine in the 1990s as board certification. I had mentally prepared myself (or so I had thought) to handle this critique of my billing …