FAQ #8
       
Do different Medicare carriers have different rules when auditing E/M documentation?

Answer: Unfortunately, the answer to this question is a resounding "yes." Medicare carriers are private insurance companies who contract with the federal government to administer the Medicare program in various states. Despite the fact that they are all supposed to follow the E/M guidelines, different carriers have different rules when it comes to auditing physician documentation for E/M services. Sometimes the differences are small, such as not allowing certain shortcuts like, "All other systems reviewed and are negative." On the other hand, sometimes the differences are huge. For example the TrailBlazer Medicare carrier has invented a completely new way to quantify the key component of medical decision-making. This means that some providers have to work harder than others to qualify for the same level of cognitive labor. To search carriers by state, click HERE.