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Payment Code Change May Hinder Medicare Whistleblowers

Aug. 20, 2018, 9:00 PM

Proposed medical coding changes for office visits and outpatient services could mean doctors face fewer false claims lawsuits related to Medicare coding errors, some health-care attorneys predict. But whether that is a good thing depends on who you ask.

The Centers for Medicare & Medicaid Services in July proposed combining four evaluation and management (E/M) code levels to reduce the administrative burden for doctors and improve payment accuracy. E/M codes are used to determine how much a doctor should bill Medicare for certain services ranging from simple blood pressure checks to more complicated medical exams that could last longer than ...